An estimated 15 million people in the United States have a current diagnosis of dysphagia, and approximately one million people annually receive a new diagnosis of dysphagia. (McQuaid 2011). Dysphagia is simply defined as difficulty swallowing.
Dysphagia can affect the oral, pharyngeal, esophageal or any combination of the three stages of swallowing. Swallowing difficulties can present with difficulty chewing certain foods, difficulty keeping food down after the swallow, and an inability to maintain adequate nutrition and hydration to function. Dysphagia profoundly affects quality of life; people with dysphagia experience discomfort and a drastic reduction in the quality of their lifestyles due to the inconvenience and pain of feeding tubes, which for many has been the primary treatment option for this condition. The loss of swallowing can also lead to severe depression due to the interruption of patients’ normal way of life. The goal of Safe Transitions with Dysphagia is to maximize the person’s and caregivers’ understanding of dysphagia, its treatments and any diet modifications to enhance safety, function and independence.
Speech therapists instruct individuals in use of compensatory swallowing strategies, strengthening exercises, positioning and diet texture recommendations to increase overall safety when swallowing to promote a safe, healthy, and satisfying lifestyle.
Signs that someone may be suffering from dysphagia include, but are not limited to: coughing during or after a meal, runny nose, watery eyes, poor appetite, refusal to swallow, spitting foods out, pocketing foods in the oral cavity, temperature spikes after meals, and certain pneumonias. The most common causes of dysphagia are: Stroke, Parkinson’s, ALS, Alzheimer’s, dementia, TBI, MS, CP, cancers or injuries to head, neck and throat, nerve damage and even medications. Therapists can screen for issues with swallowing using observation, and asking directed questions, including po intake, medication provision and any self-reported complaints.
While there are many modes of treatment and compensatory strategies used to increase ability and safety during intake, some of the more common treatments for dysphagia are:
Oral Motor Exercises: exercises for the lips and tongue to increase coordination and safety of swallow
Pharyngeal/Laryngeal Exercises: exercises of the pharyngeal and laryngeal musculature to promote increased coordination, decreased delay and increased effectiveness of swallow.
Compensatory Strategies: techniques to be used when eating/drinking to decrease risk of aspiration.
Diet Modification: Altering consistency of diet/viscosity of liquids to increase ability to safely consume adequate amounts of food/drink for proper nutrition/hydration while limiting risks of aspiration.