Swallowing, is a complex biomechanical and neurologic function that allows for the efficient and safe movement of food and nutrients from the oral cavity into the digestive tract. Finely coordinated and most often taken for granted, safety and efficiency of the swallowing mechanism can be compromised in some medical conditions and neurologic injuries. When this occurs, individuals may experience reduced nutritional intake, pulmonary complications, reduced enjoyment of eating, and other medical consequences of undernourishment/dehydration. Below are some conditions that may result in dysphagia, and some of the associated symptoms.
What are signs or symptoms of dysphagia?
What causes dysphagia?
A variety of factors can contribute to the development of a swallowing problem, although it is more common in older individuals. Individuals with a history of neurologic injury such as stroke, or have a known progressive neuromuscular condition may be at significant risk. In addition, individuals who have experienced lengthy recoveries or convalescence from other causes may be at risk due to loss of muscle strength throughout the body. A medical evaluation followed oftentimes by an imaging study, and a speech pathology clinical assessment will identify the underlying cause(s) and factor(s) and lead to the best treatment plan.
Weight Loss
Change in Vocal Quality
Coughing during/after meals
Frequent pulmonary infections
Choking during meals
Frequent heartburn
Drooling/Loss of food control
Slow intake/lengthy mealtimes
What can be done to help?
A first step is to discuss your concerns with your primary care provider to identify underlying medical causes, and address any immediate medical concerns such as pulmonary health and overall nutritional status. In order to delineate the exact nature and biomechanics of your individual swallow, your physician in most cases will order the "gold standard" test for dysphagia, the videofluoroscopic swallow study (VFSS) which will help to identify treatment targets and areas of muscular weakness or discoordination. This video X-ray study provides detailed views of your swallow, and is a first step in the treatment pathway. Treatment may include a combination of: food texture modification, swallow techniques that facilitate safety and efficiency, restorative muscle exercises and neuromuscular stimulation.