Dysphagia (Difficulty Swallowing)
Dysphagia is known as any type of difficulty with swallowing. It may occur at the oral, pharyngeal or esophageal stage.
Oral Dysphagia: The oral stage of swallowing is the first stage of swallowing where food/liquids are placed into the mouth, manipulated (chewed), formed into a cohesive bolus and pushed to the back of the mouth in preparation to swallow. At this stage, an individual may have difficulty keeping food and liquids inside of the mouth (which may be seen as drooling), chewing or moving the food/liquids around the mouth, forming a cohesive bolus, using the tongue to clear food from the sides of the mouth, or pushing the food/drinks back to initiate a swallow etc.
Pharyngeal Dysphagia: Once the food or liquid passes through your mouth, and into the pharynx, it approaches two ‘tubes’, which are the airway and the esophagus. There are several muscles that go to work to make sure the food then goes from the back of your throat down the esophagus (which leads to your stomach) instead of down the airway (which leads to the lungs). When the muscles involved in swallowing are working properly, they close off and protect the airway to prevent food or liquid from entering the lungs. Any food/liquids that enter the airway and pass into the lungs is called ‘aspiration’. At this stage, an individual may experience food/liquids “going down the wrong pipe” or the feeling that something feels “stuck” in their throat. It is especially important to pay close attention to changes at this stage of swallowing as frequent aspiration may lead to pneumonia, or other serious respiratory concerns.
Esophageal Dysphagia: Occurs once the food/liquids pass into the esophagus and then into the stomach. If difficulties are suspected at this stage of swallowing, the Speech-Language Pathologist will suggest further medical investigation, with a course of action being set forth by the appropriate medical team.
Assessing Swallowing Difficulties
At Magnolia Speech & Wellness, we provide both screenings and comprehensive assessments. A swallowing assessment typically includes the following:
- Gathering background information, including when the swallowing difficulties began and any medical/other contributing factors.
- Performing an oral motor examination to look at the strength and movement of the lips, tongue and jaw.
- Performing a swallowing assessment. This typically entails eating and drinking different liquids and foods while the SLP observes what is happening at each stage of swallowing. This is an extremely simple, pain free assessment that can yield amazing results.
Treating a swallowing disorder is dependent on the results of the assessment and any contributing medical/other background factors. Treatment may include any/all of the following:
- Exercises to help strengthen and improve movement of the muscles and structures involved in the oral or pharyngeal stages of swallowing (eg. lips, tongue, jaw etc.)
- Recommendations for compensatory strategies that may include modifying rate of eating/drinking, changing position while eating (always sitting up at a 90 degree position) etc.
- Suggestions for modifying the texture of the food/liquids taken. Certain food or liquid consistencies can be substituted to decrease aspiration risk. For example, thickened liquids travel more slowly than regular liquids and give the muscles more time to react, reducing the aspiration risk for some people.
- An SLP can make individualized diet texture recommendations to increase safety.
- An SLP may suggest follow up with a Physician if and when it is needed.
All treatment plans and recommendations are based on the needs and personal goals/wishes of the client and his/her family members. At Magnolia Speech & Wellness we take pride in providing in depth and easy to understand assessments and recommendations, so that clients feel at ease and can take comfort in knowing what is happening with their swallowing function and some reasons why it may be occurring. We are very much family focused and take our clients’ personal wishes into consideration with all of our recommendations.