Dysphagia & Swallowing

What are swallowing disorders?

Three Phases: Oral, Pharyngeal, Esophageal

Swallowing disorders, also called dysphagia (dis-FAY-juh), can occur at different stages in the swallowing process:

Oral phase - sucking, chewing, and moving food or liquid into the throat
Pharyngeal phase - starting the swallowing reflex, squeezing food down the throat, and closing off the airway to prevent food or liquid from entering the airway (aspiration) or to prevent choking
Esophageal phase - relaxing and tightening the openings at the top and bottom of the feeding tube in the throat (esophagus) and squeezing food through the esophagus into the stomach

What are some signs or symptoms of swallowing disorders?
Several diseases, conditions, or surgical interventions can result in swallowing problems.

General signs may include:

coughing during or right after eating or drinking
wet or gurgly sounding voice during or after eating or drinking
extra effort or time needed to chew or swallow
food or liquid leaking from the mouth or getting stuck in the mouth
recurring pneumonia or chest congestion after eating
weight loss or dehydration from not being able to eat enough

As a result, adults may have:

poor nutrition or dehydration
risk of aspiration (food or liquid entering the airway), which can lead to pneumonia and chronic lung disease
less enjoyment of eating or drinking
embarrassment or isolation in social situations involving eating

Dysphagia and Swallowing

How are swallowing disorders diagnosed?

A Speech-Language Pathologist (SLP) who specializes in swallowing disorders can evaluate individuals who are experiencing problems eating and drinking. The SLP will take a careful history of medical conditions and symptoms

look at the strength and movement of the muscles involved in swallowing
observe feeding to see posture, behavior, and oral movements during eating and drinking
possibly perform special tests to evaluate swallowing, such as modified barium swallow - individual eats or drinks food or liquid with barium in it, and then the swallowing process is viewed on an X-ray
endoscopic assessment - a lighted scope is inserted through the nose, and then the swallow can be viewed on a screen

What treatments are available for people with swallowing disorders? Treatment depends on the cause, symptoms, and type of swallowing problem.

A Speech-Language Pathologist may recommend:

specific swallowing treatment (e.g., exercises to improve muscle movement)
positions or strategies to help the individual swallow more effectively
specific food and liquid textures that are easier and safer to swallow

After the evaluation, family members or caregivers can help by:

asking questions to understand the problem and the recommended treatment
assisting in following the treatment plan
help with exercises
prepare the recommended textures of food and liquid, making sure that recommendations for eating safely are followed
keep track of how much food or liquid is consumed