In how it can be treated. Case

In the following lesson you will learn about dysphagia and who is at a risk for developing it. After reading this lesson, you should have a better understanding of why dysphagia can be dangerous to your health and how it can be treated.

Case Study

William is an 83-year-old man. His daughter Carol notices that he’s been losing weight, so she decides to take him out to lunch and try to get him to eat a big meal.

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During the lunch, William coughs several times while trying to swallow his food. He tells his daughter that sometimes it feels like the food gets stuck in his throat. Carol suggests it might be a good idea to visit the doctor and make sure there’s nothing serious going on. The doctor says the symptoms indicate William may have dysphagia, and he wants to run some tests for confirmation. Neither William nor Carol are familiar with the term — should they be concerned?

What is Dysphagia?

Dysphagia is difficulty swallowing. The mouth and throat are made up of a system of muscles and nerves that work together to control swallowing. Food is chewed in the mouth and mixed with saliva to get it to a consistency that is easy to swallow into the digestive tract.

If the muscles and nerves are not working properly then difficulties arise and swallowing does not happen correctly. When problems arise with swallowing, there is a risk that food can travel into the respiratory tract (larynx) instead of the digestive tract (esophagus). Over time this can lead to serious infections and pneumonias.

Dysphagia is found primarily in the elderly because their muscles lose strength over time, and they are more likely to develop illnesses that cause dysphagia. The biggest problems with dysphagia are malnutrition, dehydration and respiratory infections. William and Carol are correct to be concerned because if William does have dysphagia then it could impact his health in other ways.

Causes of Dysphagia

Dysphagia is caused when there is a weakness in the nerves and muscles that control swallowing.

It only takes one of the many muscles and nerves in the throat to become weak or damaged and cause dysfunction while swallowing.There are several diseases that can cause dysphagia, including Parkinson’s, Multiple Sclerosis and cerebral palsy. These illnesses are all related to an overall weakening of the body including the muscles that control swallowing. Brain injuries such as a stroke can also lead to dysphagia, as they can cause weakness or loss of sensation. Cancers of the head and neck can lead to dysphagia if a tumor or growth impedes the swallowing process.

While William did not have any of these illnesses that we know of, he is at a higher risk for dysphagia because of his age.

Symptoms of Dysphagia

Some people have obvious symptoms such as coughing when eating. Some people feel pain when swallowing or report that they feel like the food is getting stuck. Other people have no symptoms at all, which can be dangerous because over time liquids and foods can be going into the respiratory tract.

These individuals have ‘silent aspiration’, meaning liquid is going into the lungs and they may or may not have symptoms like frequent pneumonias. Other symptoms of dysphagia include weight loss, a hoarse voice can develop over time, drooling and reflux or regurgitating of food.

Treatment of Dysphagia

It is extremely important to treat individuals with dysphagia as it can cause weight loss and malnutrition over time as well as dangerous respiratory infections. The first way to treat dysphagia is by thickening foods and liquids, since thin liquids like water are often easier to aspirate into the lungs than a thicker consistency like a pudding. Thickening liquids is usually done in consultation with a speech pathologist and doctor to ensure foods are safely getting into the digestive tract.

Positioning the head in a certain manner can also be helpful in dealing with dysphasia. For some individuals the head needs to be straight, while others might need to turn their head to ensure proper swallowing is occurring.If an individual is not able to swallow safely with these modifications then they often need a feeding tube. A feeding tube allows an individual to get the nutrition they need without the stress of swallowing the food.

Either a nasogastric (NG) or a gastronomy tube will be placed. An NG tube goes up the nose and through the esophagus into the stomach. A gastronomy tube is placed directly into the stomach and bypasses the entire upper digestive tract so food does not need to be swallowed. For an individual with a constriction from a growth or tumor, surgery is needed to remove the growth to safely swallow.

Summary Points

Dysphagia can be potentially dangerous as it can lead to malnutrition and respiratory illnesses.

It is defined as difficulty swallowing and occurs most frequently in the elderly because of their overall weakness and risk for developing other diseases that cause dysphagia (stroke, Parkinson’s). Some individuals will have symptoms such as coughing or choking when swallowing, while others will have no symptoms at all even if liquid is going into their lungs.To treat dysphagia, liquids are often thickened to a consistency so that they will not travel into the lungs. The head can be positioned to help swallow safely, and in extreme cases, a feeding tube is placed. William’s doctor was concerned about dysphagia because he was losing weight and coughing when eating his food. Hopefully William’s case is not too serious and the solution will be as simple as thickening his foods.Medical Disclaimer: The information on this site is for your information only and is not a substitute for professional medical advice.

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