More than 65% of people have swallowing problems at sometime in their lives and 40% don't know it. At our rehabilitation clinics, speech therapists and speech language pathologists work with patients to diagnose, treat and manage swallowing disorders.
Swallowing disorders, also called dysphagia, can occur at different stages in the swallowing process:
- Oral Phase - sucking, chewing and moving food or liquid into the throat.
- Pharyngeal Phase - starting the swallowing reflex, squeezing food down the throat and closing the airway to prevent food or liquid from entering the airway (aspiration) or to prevent choking
- Esophageal Phase - relaxing and tightening the opening at the top and bottom of the feeding tube in the throat (esophagus) and squeezing food through the esophagus into the stomach
Dysphagia may also predispose patients to other medical conditions, such as:
- muscle wasting
- death from asphyxia
- chronic malnutrition
- physical debilitation
- significant weight loss
- elevated infection rate
How are swallowing disorders diagnosed?
A speech-language pathologist (SLP) who specializes in swallowing disorders can evaluate individuals who are experiencing problems eating and drinking.
The Speech Language Pathologist will:
- complete a thorough history of medical conditions and
- look at the strength and coordination of the muscles involved in swallowing,
- observe feeding to see posture, behavior and oral movements during eating and drinking, and
- possibly perform special tests to evaluate swallowing, such as a modified barium swallow or flexible endoscopic evaluation of swallowing (FEES).
What are some signs and symptoms of swallowing disorders?
In infants and children
- Sucking difficulties, failure to thrive or GERD (reflux disease)
- Developmental issues such as premature birth, cerebral palsy and fetal alcohol syndrome can cause disorders
- Coughing during or right after eating or drinking
- Wet or gurgly sounding voice during or after eating or drinking
- Extra effort or time needed to chew or swallow
- Food or liquid leaking from the mouth or getting stuck in the mouth
- Recurring pneumonia or chest congestion after eating
- Weight loss or dehydration from not being able to eat enough
How are swallowing disorders treated?
Traditional methods to treat dysphagia include:
- face and throat muscle strengthening
- patient education
- swallowing maneuvers to increase safety and ability
- physiologic exercises
- thermal stimulation
- diet alterations
- food presentation strategies
New treatments are always evolving. Some have great potential to positively impact dysphagia and speed up recovery. Treatments offered by CMH Speech Language Pahtologists include:
Modified Barium Swallow:
Barium is a harmless chalky liquid used in X-ray procedures. The patient eats or drinks food or liquid with barium in it while the swallowing process is viewed on an X-ray.
FEES - Endoscopic Assessment
A lighted scope is inserted through the nose so that swallowing can be viewed on a video monitor.
Other methods of treatment
Neuromuscular elecrical stimulation (NMES) is yielding good outcomes in both inpatient and outpatient settings. The use of surface electromyography (EMG) is another promising modailty in which feedback about muscle activity level encourages patients to swallow.