During May, which is Better Hearing and Speech Month, communication disorders and swallowing disorders are of interest to many as there is an increased awareness of these conditions as a result of the campaign.
What is Dysphagia?
The dysphagia definition is that it is a type of swallowing disorder where it takes more effort and time for you to move foods or liquids to your stomach, from your mouth. Swallowing disorders could also be linked with pain and sometimes, it may be impossible to swallow at all. You may experience problems with swallowing on occasion, such as if you don't chew your food good enough or you eat too quickly and this isn't a cause for concern.
However, if you're experiencing persistent dysphagia, it could be an indication of a more serious medical problem or condition that requires treatment. Dysphagia can cause despair and mortality.
While anyone at any age can have dysphagia, it's a common disorder in older adults. There are various causes of swallowing disorders and the cause will be the deciding factor in your treatment.
Causes of Swallowing Disorders and Dysphagia
Any condition that damages or weakens the nerves and muscles you use to swallow can cause dysphagia. Numerous diseases can lead to dysphagia or swallowing problems such as:
Pharynx or oral muscle dysfunction like a stroke
Brain disturbances like those caused by multiple sclerosis, Parkinson’s disease or amyotrophic lateral sclerosis (ALS)
Tumors, acid reflux or another esophageal narrowing
Achalasia (Loss of relaxation of the sphincter muscle
Individuals born with swallowing mechanism abnormalities might have difficulties swallowing normally. Newborns born with a cleft palate (opening in the roof of their mouth) can't suck properly, complicating drinking from a bottle or nursing.
Additionally, neck, head or esophagus cancer could cause swallowing problems. In some instances, treatments for these cancers can lead to dysphagia. Neck, chest and head injuries can also lead to issues swallowing. An irritation or infection can cause esophagus narrowing. And, individuals with memory loss, dementia and cognitive decline may have trouble chewing and swallowing.
Problems Due to Swallowing Disorders and Dysphagia
Dysphagia can be severe. When you can't swallow safely, you can't get enough of the proper foods you require to maintain and ideal weight and stay healthy.
Large pieces of food can enter your throat and block your air passage. And, when you have dysphagia and liquids and foods get into your airway, clearing your throat or coughing may not remove it. Food that's trapped in your airway can reach your lungs and promote the growth of harmful bacteria which can lead to aspiration pneumonia (a type of lung infection).
Some dysphagia consequences may include:
With a swallowing disorder, you may also develop a pocket outside your esophagus due to esophageal wall weakness. Food can become trapped in this abnormal pocket as well when you swallow. When sleeping or lying down, you could draw in undigested food into your throat. Food may stick to your esophagus if it’s too narrow and keep other food from entering your stomach.
Swallowing Disorder Treatment Options
Dysphagia treatments will depend on the cause or type of your swallowing problem.
Home Remedies and Lifestyle Changes
When you’re having difficulty swallowing, lifestyle changes and home remedies can be effective in some cases. However, you still need to consult with your doctor and follow their advice. While lifestyle changes and home remedies aren’t going to cure your dysphagia, they can help alleviate some of your symptoms. Here are some things you can try:
Avoid tobacco, alcohol and caffeine. These can worsen heartburn.
Try different textured foods to determine if they’ll cause you problems. Juice, coffee and other thin liquids are sometimes an issue for some individuals. Also, sticky foods like caramel or peanut butter can make it difficult for you to swallow.
Change your eating habits. Consume more frequent, smaller meals. Cut your food into small pieces, eat more slowly and chew your food thoroughly.
Esophageal dilation: If you have an esophageal stricture or achalasia (tight esophageal sphincter), the doctor will gently stretch and expand your esophagus width using an endoscope. Or, they may stretch your esophagus by passing a flexible tube — this process is known as dilation.
Medications: If GERD is causing your dysphagia, the doctor may prescribe you an oral medication that reduces the acid in your stomach. Corticosteroids can help with eosinophilic esophagitis and smooth muscle relaxants could help esophageal spasm.
Your doctor might refer you to a swallowing or speech therapist for oropharyngeal dysphagia. Through therapy, you may:
Learn exercises to help restimulate the nerves that activate your swallowing reflex or exercises that could help coordinate your swallowing muscles.
Learn swallowing techniques where you put food in your mouth or you position your head and body in a manner that helps you swallow. If you have Parkinson's disease, Alzheimer's disease or another neurological condition causing your dysphagia, you may learn new swallowing techniques and exercises that will help compensate your swallowing disorder.
If your swallowing disorder is preventing you from effectively eating and drinking, your doctor might suggest:
A feeding tube that bypasses the abnormal part of your swallowing mechanism.
A special liquid diet to avoid dehydration and maintain a healthy weight.
Surgery can help mitigate swallowing issues throat blockages or narrowing causes such as:
Vocal cord paralysis
After surgery, swallowing and speech therapy is helpful.
The type of surgery your doctor recommends will depend on what's causing your dysphagia. Some potential types of surgery include:
Stent placement: The surgeon inserts a plastic or metal tube (stent) into your esophagus to open a blockage or narrowing of your esophagus. Some stents are temporary where you can have them removed later and others are permanent, like in the example of esophageal cancer.
Laparoscopic Heller Myotomy: The surgeon cuts the muscle at your sphincter (lower end of the esophagus) when it’s not opening and releasing food into your stomach — in the case of achalasia.
Researchers and scientists are conducting studies to enhance speech-language pathologists' and physicians' ability to evaluate and treat dysphagia. They're studying all swallowing process components in people of all ages — even individuals without dysphagia so they better understand and compare disordered and normal processes.
If you have a gradual or sudden change in how you swallow, consult with us here at Houston ENT & Allergy Services by completing our online form or by calling us at 281-623-1312. We will evaluate you and provide you with treatment for your swallowing disorder. If you have a neurologic disorder or stroke that's causing your dysphagia, we may refer you to a neurologist. Either way, we’ll first give you a complete physical exam and perform some testing to diagnose the cause of your dysphagia and best treatment protocol.
Click the button below to learn more about the Houston Voice and Swallowing Center and it's physician Michael Underbrink, MD