We don’t have great data on how common it is for people to have trouble swallowing. But research suggests that between 8% and 22% of adults over 50 have trouble swallowing, and up to 60% in nursing homes. Common or not, having trouble swallowing is a red flag that should be addressed.
Free DIRECT download: Having trouble swallowing? (patient handout). (Email subscribers get free access to all the resources in the Free Subscription Library.)
Outline:
- What are the symptoms of a swallowing impairment?
- Why should I tell my doctor about my symptoms?
- What is the medical term for a swallowing impairment (and how do you say it)?
- How is dysphagia diagnosed?
- Show me videos of the swallow tests.
- What is the treatment for dysphagia?
- What are some things I can try?
- Where can I learn more about swallowing impairments?
- Related Eat, Speak, & Think posts.
What are the symptoms of a swallowing impairment?
You may notice changes in the oral phase (what happens in the mouth), the pharyngeal phase (what happens in the throat), or the esophageal phase (what happens in the chest).
You can read more about the signs and symptoms of dysphagia, but here are some common symptoms you may notice when eating or drinking, or shortly afterward:
- Trouble chewing food well enough to swallow comfortably.
- Food or liquid left over in the mouth after swallowing.
- Feeling like food, liquid, or pills are stuck in your throat or chest.
- Trouble swallowing food, liquid, or pills.
- Coughing or clearing your throat often while eating or drinking.
Other symptoms of a swallowing problem can be more subtle, such as:
- Drooling.
- Having a weak cough or a wet-sounding voice.
- Avoiding certain foods or liquids for unknown reasons.
- Unintended weight loss.
- Chronic dehydration.
- Aspiration pneumonia.
Why should I tell my doctor about these symptoms?
A swallowing impairment can result in unfortunate problems such as:
- Choking.
- Aspiration of food, pills, or liquids into the lungs.
- Dehydration.
- Malnutrition.
- Decrease in social interaction (which is often centered around food).
- Depression.
Trouble swallowing is caused by one or more medical conditions. Sometimes, difficulty swallowing is an early warning sign of a medical condition. Diagnosing the swallowing problem can lead to treatment for the underlying medical cause.
There are many possible causes for dysphagia, including:
- Dry mouth.
- Problems with your teeth or dentures.
- Altered mental status, which may indicate an acute problem such as a urinary tract infection or pneumonia.
- GERD (gastroesophageal reflux disease).
- A problem with the esophagus, which leads from the throat to the stomach.
- Stroke or head injury.
- Cancer of the head or neck.
- Alzheimer’s disease.
- Parkinson’s disease.
- ALS (Lou Gehrig’s disease) or other progressive neurological disease.
What is the medical term for a swallowing impairment (and how do you say it)?
The medical term for a swallowing impairment is dysphagia. It comes from Greek, where dys means “disordered” and phage means “eat”.
Listen to various professionals say the word in this short video:
How is dysphagia diagnosed?
Dysphagia is diagnosed by a professional with special training in swallowing, which typically is a speech-language pathologist (SLP) in the US. Physicians, particularly ENTs and gastroenterologists, may also diagnose dysphagia. My understanding is that Occupational Therapists may also diagnose dysphagia, particularly in the western part of the US. In this post, I’ll talk about how SLPs diagnose swallowing impairments.
Diagnosing a swallowing impairment includes the following steps:
- Reviewing your medical history.
- Interviewing you to learn about the problems you’re experiencing.
- Doing a physical exam to see how your lips, tongue, jaw, and throat are working.
Based on this initial information, your SLP may do one or more of the following.
- Clinical Swallow Evaluation – assess how you drink or chew and swallow food.
- Perform or refer you for an instrumental swallow test to look inside as you eat and drink.
There are two types of instrumental swallow tests, one using an endoscopic camera and the other using an x-ray machine. Both tests are valid and provide useful information to your medical team.
Show me videos of the swallow tests
The endoscopic test is called a FEES (Fiberoptic Endoscopic Evaluation of the Swallow). A small camera is passed through the nose and hangs in the back of the throat, allowing the SLP to watch what happens as you eat and drink that have been dyed with food coloring. Here is what it looks like:
The test using x-rays goes by different names, such as a (MBSS) Modified Barium Swallow Study or a VFSE (Video Fluoroscopic Swallowing Exam). This test allows the SLP and the physician operating the x-ray machine to watch what happens to barium-coated food and liquid barium as you eat and drink. Here’s an example:
What is the treatment for dysphagia?
Treatment for dysphagia varies greatly, depending on the severity of the problem and its cause. It’s important to realize that treatment should be directed by a trained professional who has examined you directly. This information is provided for education only.
Your SLP may help with some or all of these treatment options:
- Changing your environment, such as how you sit and how your table is set up.
- Training you how to eat and drink more safely and comfortably.
- Teaching you exercises to improve your swallowing ability.
- Showing you how to alter foods or liquids to make them easier to swallow.
What are some things I can try?
Here are some commonsense general tips which are not intended as treatment advice. If you have any concerns about your swallowing, report them to your physician. If any of these tips worsen your symptoms, stop immediately.
- Sit all the way up when you eat or drink.
- Don’t talk with food in your mouth.
- Take small bites and chew well.
- Sips liquids frequently to help wash food down.
Don’t lie down immediately after you eat to allow time for the food to start passing through the digestive system. Lying down too soon could allow food or liquid to come back up into the throat.
Another tip is to brush your teeth and tongue (or gums & tongue if you don’t have teeth) at least every morning and night. This is to remove bacteria that could cause an aspiration pneumonia if you happen to aspirate saliva, food, beverages, or medication into your lungs.
Where can I learn more about swallowing impairments?
The National Foundation of Swallowing Disorders provides education and support for people who have a swallowing impairment.
If you’ve been diagnosed with a condition, try doing an online search for “the name of the condition + swallowing” to find out if swallowing problems are common in that situation. If so, you’ll find information that is more specific to that condition.
Related Eat, Speak, & Think posts
- 10 factors that increase risk of aspiration pneumonia.
- Take the guesswork out of thickening liquids with the IDDSI flow test.
- A practical guide to pureed food at home.
- ALS guide for SLPs.
Free DIRECT download: Having trouble swallowing? (patient handout). (Email subscribers get free access to all the resources in the Free Subscription Library.)
Featured image by Snapwire from Pexels.
Lisa earned her M.A. in Speech-Language Pathology from the University of Maryland, College Park and her M.A. in Linguistics from the University of California, San Diego.
She participated in research studies with the National Institute on Deafness and other Communication Disorders (NIDCD) and the University of Maryland in the areas of aphasia, Parkinson’s Disease, epilepsy, and fluency disorders.
Lisa has been working as a medical speech-language pathologist since 2008. She has a strong passion for evidence-based assessment and therapy, having earned five ASHA Awards for Professional Participation in Continuing Education.
She launched EatSpeakThink.com in June 2018 to help other clinicians be more successful working in home health, as well as to provide strategies and resources to people living with problems eating, speaking, or thinking.
Be First to Comment