Dysphagia/swallowing disorder is simply difficulty in swallowing. Difficulties can occur in any of four stages of swallow which correspond to the location of the food bolus as it moves through the system:
- Oral Preparatory Phase: Chewing and mixing of food with saliva to form soft bolus.
- Oral Phase: The food is transmitted with the help of tongue and it's interaction with palate, teeth and cheeks to the oropharynx.
- Pharyngeal Phase: The airway is closed to prevent the food from getting into the lungs. The bolus is moved through the pharynx to the esophagus.
- Esophageal Phase: The contraction of esophagus move the food into the stomach
Dysphagia occurs in all age groups and may arise from
- Mechanical problems : Tracheostomy tube, Oedema, Tumor, Cervical spine displacement etc.
- Surgical causes: Glossectomy, surgical reconstruction of jaw, Laryngectomy.
- Neurological causes : Cerebral palsy, Stroke/Cerebrovascular accident, Encephalitis, Meningitis, Multiple sclerosis, Parkinson's disease, Huntington's disease, Traumatic brain injury, Myasthenia gravis etc.
- Psychogenic/Hysterical :Dysphagia is often accompanied by emotional distress and disturbance. It is characterised by refusal to eat because of an imagined obstruction in the throat.
The most common signs and symptoms of dysphagia include
- Increased effort and time to chew and swallow
- Cough/throat clearing during or after eating or drinking
- Gurgly voice after swallow
- Recurrent pneumonia
- Malnutrition and
- Weight loss
The difficulty in swallowing may lead to decline in general health and quality of life.
Swallowing therapy provides evaluation and treatment for individuals with swallowing problems. A speech language pathologist (SLP) assess and treat dysphagia using compensatory and rehabilitative therapy to improve the safety of oral intake by reducing your risk for aspiration and maintaining quality of life.
Compensatory swallowing therapy involves exercises for the organs of swallowing to strengthen control of the voluntary oral preparatory and oral phase of swallowing.
Rehabilitative therapy combine the use of various consistencies of foods and liquids to practise swallowing techniques and maneuvers, including compensatory exercises.
An SLP also recommend an individual diet plan, modification of food and liquid consistencies to improve control of allow for safe oral intake.