Swallowing is a large part of life that most of us rightly take for granted. However, when problems develop that make it more difficult to swallow, it can make life in general more difficult. Swallowing disorder, also known as dysphagia, comes in all kinds of forms. It can be the complication of another condition or entirely stand alone. A condition that can range from annoying to debilitating, 22% of the adult population is thought to suffer with dysphagia. Below, we take a look at the symptoms and causes, as well as some of the treatment options available for swallowing disorder.
Besides having difficulty swallowing, there are a lot of symptoms that present with dysphagia. Some can be helpful where someone with limited communication skills suffer from dysphagia. The symptoms can also help you identify the causes, some of which are separate medical issues like a swollen uvula. Having pain when swallowing, up to the extent of being unable to swallow, are the main symptoms. It’s not just in the throat, however. Sometimes it may feel like food is getting stuck in the back of your throat or even behind your chest. In those who need care, excessive drooling and coughing or gagging when swallowing are some of the symptoms to look out for. If these issues result in regurgitation, vomiting or weight loss, then the condition is severe. These are the cases in which medical assistance should be sought immediately.
The causes of swallowing disorder are far ranging. Some of them are preventable whilst others can strike randomly and suddenly. Any abnormalities or swelling in the body parts that facilitate swallowing can cause it. This includes the tongue which is used to push food. It also includes the muscles of the throat and the oesophagus. Anatomical obstruction is the most common of causes for dysphagia, but far from the only one. Diseases of the brain that damage control of nerves and reflexes can also be the culprit. Dysphagia is one of the more common results of suffering a stroke, for example. Other mental conditions can cause it, too. Amyotrophic lateral sclerosis. Parkinson’s disease. Multiple sclerosis. Cerebral palsy. It can also develop as a result of a head injury. Diseases related to the oesophagus and connective tissues are other causes. Dysphagia rarely occurs by itself, but usually as a result of a disease or anatomical obstruction.
Treatment for swallowing disorder usually starts with diagnosis of what’s causing it. This can be through the use of a camera or x-ray, or through more invasive measures. These are often how the underlying cause of swallowing disorder is found and treated. However, if swallowing disorder remains, it can be difficult to find the right specialists. Many sufferers have experienced frustration when dealing with physicians who sometimes misunderstand the cause. The kind of specialist most commonly used to deal with dysphagia is a speech-language pathologist. Communication disorders often deal the throat and tongue. So speech-language pathologists are qualified to inspect these parts of the body. Not all speech-language pathologists have the expertise necessary to treat people with swallowing disorder. Those that do can be identified with qualifications. Usually from the Speciality Board for Swallowing and Swallowing Disorders or similar institutions.
One of the most common treatments for those with swallowing disorders. These exercises tackle the muscles and parts of the body that facilitate swallowing. This is primarily done through a regimen of exercise. These exercises are designed to strengthen the tongue, throat and oesophagus. It may also include surrounding muscle and connective tissue. These exercises should not be done without the recommendation of a speech-language pathologist. Or whatever physician is in charge of your treatment. Doing them without the go-ahead could result in injury that only exacerbates your condition. However, if you are given the go ahead, there are different exercises that can help. An effortful swallow involves collecting all the saliva in your mouth on your tongue and swallowing. An isokinetic shaker involves lying down and repeating movements of the head. Others include vocal exercises and improving the motion of your tongue. Exercise is a long-term method of tackling those with more chronic issues. It may not be necessary in those with short term anatomical obstructions, for instance.
Eating is one of the primary concerns of those with swallowing disorders because it is most basic human need affected by it. Suffering from swallowing disorder means that the way you take your diet will often have to change drastically. It depends on the severity of the disorder. Some are able to eat as they would regularly, using smaller portions to take their meals instead. Others, however, are much less able to consume solids. Instead, they might have to rely on soups and liquid nutrition. Sites like http://thickit.com/products/purees/recipes/ help ensure all the necessary nutrition is still received. Others still have to rely on tube feeding since they are unable to swallow at all. Depending on the severity of your condition, ask your doctor or speech-language pathologist which method is best for you.
There are several ways that a swallowing disorder can be made worse. More care should be taken to avoid any additional anatomical obstructions like abscesses. Proper oral hygiene plays a large role in avoiding abscesses and infections. Suffering from a dry mouth is another factor that will make it all the more difficult to swallow. Dry mouth can be caused by dehydration, so making sure you get plenty of water is one thing to focus on. Certain foods like crackers and caffeinated drinks can also cause a dry mouth. A room humidifier can be a good addition and you should always breathe through your nose, not through your mouth. Mouthwashes and saliva substitutes can also be bought over-the-counter. http://www.mayoclinic.org/diseases-conditions/dry-mouth/expert-answers/dry-mouth/faq-20058424 recommends keeping an eye out for the ingredient xylitol. Saliva Is an important part of your health besides maintaining dysphagia, so fight dry mouth as often as you can.
In the case of infections and diseases, it is likely that medication will be prescribed to deal with the cause of swallowing disorder. However, the nature of the disorder means that patients can often find it difficult to swallow pills. For some, it may be enough to simply cut the pill into smaller pieces that are more easily swallowed. http://www.nhs.uk/conditions/swallowing-pills/Pages/swallowing-pills.aspx has information to consider when crushing or cutting pills. Only certain tablets or pills can be crushed or soaking in water to make them easier to swallow, for example. Sustained release or time release pills should never be taken in this way, for example. You may also be able to request medication in other forms. Many medications can be delivered In liquid or dispersible forms. Creams, patches and suppositories avoid swallowing altogether. There are also legal implications for crushing, soaking or cutting medication. This is why carers should not try to do so without specific instruction from a doctor.
Some of the solutions recommended by your physical might involve physical remedies. Surgery is often used to clear any obstructions that cause swallowing disorder. You may also be recommended for use of esophageal dilation. This involves applying anaesthetic before inserting a dilator to strength or widen the oesophagus. This is most often used in the case where frequent heartburn of acid reflux cause scarring of the oesophagus. Those who take prescription blood thinners or aspirin may not eligible for this procedure. Esophageal dilation rarely involves any side effects besides some discomfort or minor lingering pain. However, as an invasive manoeuvre, it is often used only after other treatments have failed. A more common procedure in the insertion of a feeding tube. Percutaneous endoscopic gastronomy tubes are put directly into the stomach in these cases.
Caring for others with swallowing disorder
As a lot of those suffering with long-term swallowing disorder suffer from mental disorders, it is likely that a lot of them will have carers. Carers should be more mindful of symptoms like excessive drooling and regurgitation. They should also avoid modifying any medication as mentioned above. Caregivers should also take note of how they help feed patients with swallowing disorders. Pay attention to the consistency of any food or liquid and position the head and body carefully before feeding. Frequently check the mouth and throat, if possible, for food buildup or obstructions. Avoid using feeders (like cups with spouts) since they deliver liquids directly to the back of the throat and can cause choking.
Swallowing disorders are varied and come in different severities. Some can be short term and rely on the treatment of an infection or abscess to disappear. Others can stick with us for life and need constant treatment. There are many forms of treatment and many causes. The knowledge of a specialist and careful monitoring are needed to find the best treatments possible. Don’t try tackling this disorder yourself as you can often exacerbate it that way.