Dysphagia is a condition that affects how a person swallows. This can make it difficult to eat, drink, and speak. With the help of a speech therapist, you can learn how to manage this condition.
Imagine experiencing the inability to swallow food, without coughing and choking. You would not be alone. According to ASHA, the governing body for speech-language pathologists, approximately one in 25 adults will experience a swallowing problem in the United States. As speech-language pathologists, we help with these types of motor or physical disorders.
Dysphagia and swallowing disorders, can be complicated to treat.
Swallowing is one of the things we take for granted…. Until we can’t do it any longer. Swallowing involves more than 20 muscles of the mouth, throat, and esophagus. These muscles receive commands from the brain. For this reason, a swallowing disorder can occur from problems in the brain, nerves, or muscles.
Dysphagia case example from a speech therapist:
During my first clinical experience in a hospital setting, I met Mr. Smith. He was a good friend of my grandfather’s as they had been on a bowling team for many years. Mr. Smith had experienced a moderate CVA (cerebral vascular accident) the day before. His doctor had recommended him to be NPO (nothing per oral) until a swallow study could be done to make sure he was able to swallow safely. Let’s take a closer look at how swallowing works and how Mr. Smith’s swallow was affected by his CVA.
A swallowing disorder, or a disorder in deglutition, is referred to as dysphagia. Dysphagia is a disorder described as a regular difficulty swallowing or moving foods from the mouth to the stomach.
There are four different stages of the swallow. These stages consist of:
- Pre-oral phase: This is the portion of the swallow that occurs before the food or drink is placed into our mouth. During the pre-oral phase, we see and/or smell the food. Our body anticipates eating and hunger followed by salivation may occur. Of course, if the food item is something you don’t like to eat, you won’t feel hunger and salivation won’t occur. Salivating assists in the swallowing process by helping us break down the food through softening and moistening the food.
- Oral preparatory phase: During this phase, our lips form a seal to keep the food and/or liquid from escaping out of our mouth. Chewing begins, and the food is formed into a “ball” of food to allow easier transport to the back of the mouth.
- Pharyngeal phase: This stage of the swallow occurs rapidly, and lasts less than a second. It begins with the initiation of the pharyngeal swallow. This moves the bolus of food through the “food tube” (pharynx) through muscular contractions.
Swallowing problems happening at any of these stages can be mild or severe. And the treatment varies depending on what’s causing the problem.
Sometimes, doctors can prescribe medication to help you swallow. If you’re unable to swallow anything at all, you may need a feeding tube to get the nourishment you need.
After a swallowing study, a speech therapist can provide swallowing therapy to help dysphagia.
A swallow study is often completed to determine what types of food items a person can swallow safely. In some more severe cases, a person may engage in silent aspiration. This is when food or liquids enter into the airway and/or lungs during the process of swallowing and the patient does not demonstrate any coughing or choking behaviors. When someone with an intact swallow has food or water enter into their airway or lungs, they would demonstrate extreme coughing or choking. (I find myself doing this when I am watching TV and lying back in my bed.) Chronic aspiration can lead to aspiration pneumonia, which can be life-threatening.
Swallowing therapy is one of the treatments for dysphagia. A speech-language pathologist can provide swallowing therapy with a doctor’s order. The treatment is specialized depending upon where in the swallowing process the breakdown occurs. Changing one’s diet can also assist in helping someone with dysphagia to swallow safely.
Let’s check back in on Mr. Smith. His swallow study showed he was unsafe to drink thin liquids like water due to aspiration. His physician approved the speech-language pathologist’s recommendation to thicken his liquids to a nectar-thick consistency and implement swallowing therapy immediately.
How swallowing therapy got Mr. Smith back to his regular routine
I was a part of Mr. Smith’s treatment team. Part of his plan was to receive swallowing therapy two times a day during his hospital stay. During his sessions we completed safe swallowing techniques such as a chin tuck. When Mr. Smith tucked his chin to his chest, his swallow reflex was more timely and he demonstrated no obvious signs or symptoms of aspiration. Over the course of his hospital stay, his swallowing improved significantly. He was discharged to home where he continued to receive speech therapy via home health. We were able to attempt thin liquids again, and a follow-up swallow study two weeks later showed his swallowing had returned to being safe for a soft diet with thin liquids.
If you, or someone you know has a swallowing problem, Better Speech can help.
The speech-language pathologists at Better Speech have the training and experience in treating dysphagia for our clients. The best part is, treatment is done in the comfort of your own home via Zoom link (telehealth). If you have any questions about dysphagia and its treatment, you can click here to schedule a free consultation.