What Is Dysphagia?
People with upset have issues swallowing and will even experience pain whereas swallowing (odynophagia). Some folks could also be fully unable to swallow or may have the hassle of safely swallowing liquids, foods, or saliva. Once that happens, feeding becomes a challenge. Often, dysphagia makes it tough to require enough calories and fluids to nourish the body and might result in further serious medical problems.Dysphagia is commonly noted in stroke survivors and can have an effect on the oral and/or tubular cavity section of swallowing. The patient may cough or choke while trying to swallow saliva, liquids, or food. A speech-language diagnostician often assesses a patient’s ability to swallow so as to see the chance of aspiration, (food or liquid going into the respiratory organs) that doubtless might result in a lung infection or pneumonia.
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| Dysphagia |
Stroke survivors are in danger of silent aspiration. Silent aspiration is once food and liquid enter into the lungs with none coughing or choking. In these patients, there are not any outward signs or symptoms of a swallowing problem.Swallowing could be a complicated process. Some fifty pairs of muscles and plenty of nerves work to receive food into the mouth, prepare it, and move it from the mouth to the stomach. This happens in 3 stages. Throughout the primary stage, known as the oral phase, the tongue collects the food or liquid, creating it prepared for swallowing. The tongue and jaw move therefore lid food around within the mouth so it is chewed. Manduction makes solid food the correct size and texture to swallow by compounding the food with saliva. secretion softens and moistens the food to form swallowing easier. Normally, the sole solid we have a tendency to swallow while not chewing is in the type of a pill or caplet. Everything else that we swallow is in the form of a liquid, a puree, or a chewed solid.
The second stage begins once the tongue pushes the food or liquid to the rear of the mouth. This triggers a swallowing response that passes the food through the pharynx, or throat (see figure). Throughout this phase, known as the tubular cavity phase, the vocal organ (voice box) closes tightly and respiration stops to forestall food or liquid from coming into the airway and lungs.
The third stage begins when food or liquid enters the esophagus, the tube that carries food and liquid to the stomach. The passage through the esophagus, called the musculature phase, typically occurs in approximately 3 seconds, counting on the feel or consistency of the food, however will take slightly longer in some cases, adore once swallowing a pill.
Medical term
Dysphagia is difficulty swallowing — taking longer and energy to maneuver food or liquid from your mouth to your stomach. upset may be painful. In some cases, swallowing is impossible. Occasional issue swallowing, reminiscent of after you eat too quickly or don't chew your food well enough, sometimes isn't cause for concern. However persistent dysphagia will be a heavy medical condition requiring treatment. upset can occur at any age, but it's additional common in older adults. The causes of swallowing issues vary, and treatment depends on the cause.
Dysphagia is the medical term for difficulty swallowing It is a very common condition especially among older adults The most common type of dysphagia occurs when a person has trouble moving food from the mouth to the stomach or when food gets stuck in one place along the way This kind of dysphagia may be due to a disease that affects brain function like Alzheimer's disease or Parkinson's disease or it may be caused by structural problems in the throat and esophagus (the tube through which we swallow) Swallowing disorders can also result from head and neck cancer treatments that involve radiation therapy or surgery In rare cases dysphagia.
Dysphagia causes difficulty in swallowing It can be caused by a variety of diseases or conditions including stroke cancer Parkinson’s disease and amyotrophic lateral sclerosis (ALS) A doctor usually diagnoses dysphagia A physical exam can help identify the presence of dysphagia The doctor may ask if any family member has had similar symptoms to see if there is a genetic cause of the problem The doctor will ask questions about eating habits and what happens while eating to determine if dysphagia is present Sometimes doctors order x-rays or other imaging tests to make sure that nothing else is causing the problem with swallowing If a non-food.
It can occur in any of the three phases of swallowing:
Oral
Pharyngeal
Esophageal
Symptoms Dysphagia
Some patients have the disorder and are unaware of it — in these cases, it should go unknown and not be treated, raising the danger of bronchial pneumonia (a respiratory organ infection which will develop when accidentally euphena secretion or food particles).
Signs and symptoms associated with dysphagia can include:
Pain while swallowing
Inability to swallow
A sensation of food getting stuck in the throat or chest or behind the breastbone (sternum)
Drooling
Hoarseness
Food coming back up (regurgitation)
Frequent heartburn
Food or stomach acid backing up into the throat
Weight loss
Coughing or gagging when swallowing
When to see a doctor
See your health care supplier if you frequently have issue swallowing or if weight loss, regurgitation or ejection accompanies your dysphagia. If associate degree obstruction interferes with breathing, imply emergency relief immediately. If you're unable to swallow as a result of feeling that food is stuck in your throat or chest, move to the closest emergency department.
Causes Dysphagia
Dysphagia has several doable causes and happens usually} in older adults. Any condition that weakens or damages the muscles and nerves used for swallowing might cause dysphagia. For example, individuals with diseases of the nervous system, admire brain disease or Parkinson’s disease, often have issues swallowing. Additionally, stroke or head injury may weaken or have an effect on the coordination of the swallowing muscles or limit sensation within the mouth and throat. individuals born with abnormalities of the swallowing mechanism might not be able to swallow normally. Infants who are born with a gap in the roof of the mouth (cleft palate) are unable to suck properly, which complicates nursing and drinking from an everyday baby bottle. In addition, willcer of the head, neck, or passage may cause swallowing problems. generally the treatment for these kinds of cancers can cause dysphagia. Injuries of the head, neck, and chest might also produce swallowing problems. Associate in Nursing infection or irritation can cause narrowing of the esophagus. Finally, for individuals with dementia, state of mind and psychological feature decline may build it troublesome to chew and swallow.
Swallowing is complex, involving several muscles and nerves. Any condition that weakens or damages the muscles and nerves used for swallowing or results in a narrowing of the rear of the throat or muscular structure will cause dysphagia. upset usually falls into one amongst the subsequent categories.
Esophageal dysphagia
Esophageal upset refers to the feeling of food jutting or getting caught within the base of your throat or in your chest when you've begun to swallow. a number of the causes of musculature dysphagia include:
Achalasia. When the lower musculature muscle (sphincter) doesn't relax properly to let food enter the stomach, it will cause food to return and keep a copy into the throat. Muscles within the wall of the esophagus can be weak as well, a condition that tends to worsen over time.
Diffuse spasm. This condition causes high-pressure, poorly coordinated contractions of the esophagus, sometimes when swallowing. Diffuse spasm affects the involuntary muscles within the walls of the lower esophagus.
Esophageal stricture. A narrowed musculature (stricture) will lure massive items of food. Tumors or scar tissue, usually caused by esophageal reflux sickness (GERD), can cause narrowing.
Esophageal tumors. Difficulty swallowing tends to get progressively worse when esophageal tumors are present due to narrowing of the esophagus.
Foreign bodies. Sometimes food or another object will partly block the throat or esophagus. Older adults with dentures and other people who have issued manduction their food is also a lot of probably to possess a bit of food become lodged within the throat or esophagus.
Esophageal ring. A thin area of narrowing in the lower esophagus can cause difficulty swallowing solid foods off and on.
GERD. Damage to esophageal tissues from stomach acid backing up into the esophagus can lead to spasm or scarring and narrowing of the lower esophagus.
Eosinophilic esophagitis. This condition, which might be related to a food allergy, is caused by too many cells called eosinophils in the esophagus.
Scleroderma. Development of scar-like tissue, inflicting stiffening and hardening of tissues, will weaken the lower muscle system sphincter. As a result, acid backs up into the muscle system and causes frequent heartburn.
Radiation therapy. This cancer treatment can lead to inflammation and scarring of the esophagus.
Oropharyngeal dysphagia
Certain conditions can weaken the throat muscles, making it tough to maneuver food from your mouth into your throat and gullet once you begin to swallow. you would possibly choke, gag or cough when you try to swallow or have the feeling of food or fluids happening to your cartilaginous tube (trachea) or up your nose. This may cause pneumonia.
Causes of oropharyngeal dysphagia include:
Neurological disorders. Certain disorders — such as multiple sclerosis, muscular dystrophy and Parkinson's disease — can cause dysphagia.
Neurological damage. Sudden neurological damage, such as from a stroke or brain or spinal cord injury, can affect the ability to swallow.
Pharyngoesophageal diverticulum (Zenker's diverticulum). A small pouch that forms and collects food particles within the throat, usually simply on top of the esophagus, ends up in issue swallowing, gurgling sounds, unhealthy breath, and recurrent throat clearing or coughing.
Cancer. Certain cancers and some cancer treatments, such as radiation, can cause difficulty swallowing.
Risk factors Dysphagia
The following are risk factors for dysphagia:
Aging. Due to natural aging and normal wear and tear on the esophagus likewise as a larger risk of bound conditions, such as stroke or Parkinson' disease, older adults are at higher risk of swallowing difficulties. however upset isn't thought-about a standard sign of aging.
Certain health conditions. People with certain neurological or nervous system disorders are more likely to have difficulty swallowing.
Complications Dysphagia
Difficulty swallowing can lead to:
Malnutrition, weight loss and dehydration. Dysphagia can make it difficult to take in enough nourishment and fluids.
Aspiration pneumonia. Food or liquid getting into the airway throughout an attempt to swallow will cause bronchopneumonia as a result of the food introducing bacteria into the lungs.
Choking. Food stuck within the throat will cause choking. If food utterly blocks the airway and nobody intervenes with a prosperous Heimlich maneuver, death can occur.
Prevention Dysphagia
Although swallowing difficulties can't be prevented, you'll be able to cut back your risk of occasional issue swallowing by intake slowly and manduction your food well. However, if you've got signs or symptoms of dysphagia, see your health care supplier. If you have GERD, see your health care provider for treatment.
What is the best medicine for dysphagia?
Dysphagia is difficulty swallowing which can be caused by a number of factors Some causes of dysphagia are due to biological factors that cannot be treated with medication such as neurological diseases or strokes Other causes can be treated with medical intervention and are often associated with aging These include: Medication Side Effects : Many medications have side effects that can affect the digestive system including antihistamines for allergies; antidepressants for depression; and pain relievers for arthritis Altering or stopping these medications could improve dysphagia symptoms Medicines that should not be stopped without first consulting your physician include blood-thinning drugs.
How do doctors treat dysphagia?
A physician may recommend that a person diagnosed with dysphagia consult a speech pathologist to determine the exact cause of this condition Treatment may require dietary changes or the use of special feeding tools and food supplements Speech therapy is often recommended for people suffering from swallowing disorders In some cases surgery can be used to repair damage caused by stroke or other medical conditions.
What can you do at home for dysphagia?
People who have dysphagia may benefit from a few simple exercises to strengthen the muscles in their tongue, jaw and neck. A physical therapist or speech-language pathologist should instruct you on how to perform these exercises correctly.
What foods should you avoid with dysphagia?
Dysphagia is a swallowing disorder characterized by difficulty in swallowing and/or painful swallowing It can be caused by many things including stroke brain injury cancer or other medical condition While eating the right foods is important to overall health it's especially necessary with dysphagia because of the increased risk of choking and aspiration (inhaling food into your lungs) if you eat foods that are difficult to swallow.
Can dysphagia be caused by anxiety?
Anyone who suffers from anxiety will have to deal with the physical symptoms such as a racing heart or sweaty palms However some people find that these symptoms can lead to other things including difficulty swallowing It is rare for dysphagia to be directly caused by anxiety There are multiple reasons why someone may have difficulty swallowing including damage to the esophagus or throat and muscle weakness in the mouth or throat area If you do suffer from dysphagia due to anxiety and it is causing you problems with eating and drinking safely talk to your doctor about treatment options for this condition.
Can dysphagia be caused by acid reflux?
Dysphagia or difficulty swallowing can be a symptom of a number of health conditions including acid reflux disease As many as 40 percent of patients with dysphagia have gastroesophageal reflux disease (GERD) which occurs when stomach acids back up into the esophagus and cause damage to the delicate tissue that lines the throat Symptoms of GERD include heartburn chest pain and a chronic cough Treatment options for GERD include lifestyle changes like avoiding tobacco smoke and chocolate; medication such as antacids; and surgery to tighten or protect the lower esophageal sphincter muscle at the bottom of your esophagus.
Which part of the body does dysphagia affect?
Dysphagia is the medical term for the inability to swallow The condition can be caused by a number of different health problems including stroke head or neck injury and neurological conditions such as Parkinson's disease multiple sclerosis and Huntington's disease Although dysphagia may occur at any age it is most common in people over 65 years old It occurs more frequently in women than men.
Diagnosis Dysphagia
In addition to a customary throat and cartilaginous structure examination nation, your treatment team may raise you to finish swallowing take a look at. this could embody a test performed within the office, wherever we tend to observe however you swallow with a versatile scope in your nose (a fiber-optic analysis of swallowing, or FEES test) or with X-rays of your neck and chest whereas swallowing (a changed atomic number 56 swallow study, or MBS). the mixture of a radical exam and swallow study can verify if your upset is thanks to a haul in your throat, voice box or esophagus.Your health care supplier will probably ask you for an outline and history of your swallowing difficulties, perform a physical examination, and use numerous tests to search out the reason for your swallowing problem.
Tests can include:
X-ray with a contrast material (barium X-ray). You drink a metal answer that coats your passage, creating it easier to visualize on X-rays. Your health care supplier can then see changes within the form of your esophagus and might assess the muscular activity. Your health care provider may also have you swallow solid food or a pill coated with barium to observe the muscles in your throat as you swallow or to see for blockages in your esophagus that the liquid barium solution may not identify.
Dynamic swallowing study. You swallow barium-coated foods of various consistencies. This take a look at provides a picture of those foods as they travel down your throat. The pictures may show issues within the coordination of your mouth and throat muscles after you swallow and verify whether or not food goes into your respiratory tube.
A visual examination of your esophagus (endoscopy). A thin, versatile lighted instrument (endoscope) is passed down your throat so your health care supplier will see your esophagus. Your health care provider may take biopsies of the esophagus to appear for inflammation, leukocyte esophagitis, narrowing or a tumor.
Fiber-optic endoscopic evaluation of swallowing (FEES). Your health care provider might examine your throat with a special camera and lighted tube (endoscope) as you try to swallow.
Esophageal muscle test (manometry). In manometry (muh-NOM-uh-tree), a little tube is inserted into your musculature and connected to a pressure recorder to live the muscle contractions of your esophagus as you swallow.
Imaging scans. These will embody a CT scan, which mixes a series of X-ray views and laptop process to form cross-sectional pictures of your body' bones and soft tissues, or an MRI scan, that uses a flux and radio waves to create careful images of organs and tissues.
FEES Swallowing Study
Hi, Addie. I'm Carrie. I'm a speech pathologist. I'm planning to be serving out the analysis today. we tend to be doing a {sort} of swallowing evaluation wherever we tend to place a camera in your nose. We provide you with totally different consistencies of food things to swallow and watch you swallow those. This can be the camera we're going to use. It goes in your nose regarding this far, simply a touch bit past that white line. There's not an abundant house between your nose and your throat, so it doesn't have to be compelled to get in terribly far. We're not in there very long. Just long enough to require a glance around at the ANatomy, provide you with some things to eat and drink, watch you swallow those then we tend to return out, okay. therefore the totally different things we're planning to be swallowing. We'd wish to do an assortment of consistencies, so we do a skinny liquid, a puree, and also then a solid consistency. I place a touch of inexperienced coloring within the liquid and the puree that simply permits a North American nation to check it higher once the cameras are in place. Okay.
Proceduralist: Ready?
Assistant: Some slow deep breaths.
Carrie: That's the absolute worst part right there.
Assistant: Good job.
Proceduralist: Can you see?
Assistant: Can you see it on TV?
Carrie: Only if you want.
Proceduralist: We can show you afterwards too.
Carrie: Ready for me?
Assistant: Take a couple sips of juice.
Carrie: Go ahead and take a couple more for me. Good.
Assistant: Some applesauce.
Carrie: Your other hand. Go ahead and take a bite of one of those. And one more. You can move your head a little bit. All right. That's it.
Proceduralist: Are you done?
Carrie: I'm done.
Proceduralist: On the way out. Perfect.
Assistant: You did it! Good job.
Note: This content was created before the coronavirus sickness 2019 (COVID-19) pandemic and doesn't demonstrate correct pandemic protocols. Please follow all counseled Centers for sickness management and bar pointers for masking and social distancing.
Treatment Dysphagia
There are totally different treatments for varied styles of dysphagia. Medical doctors and speech-language pathologists who evaluate and treat swallowing disorders use a spread of checks that permit them to seem at the stages of the swallowing process. One test, the versatile examination analysis of Swallowing with Sensory Testing (FEESST), uses a lighted fiber-optic tube, or endoscope, to look at the mouth and throat whereas examining however the swallowing mechanism responds to such stimuli as a puff of air, food, or liquids. A videofluoroscopic swallow study (VFSS) may be a test within which a practitioner takes a videotaped X-ray of the entire swallowing method by having you consume many foods or liquids in conjunction with the mineral Ba to enhance visibility of the biological process tract. Such pictures facilitate determining wherever within the swallowing process you're experiencing problems. Speech-language pathologists use this technique to explore what changes are often created to supply a secure strategy once swallowing. The changes could also be in food texture, size, head and neck posture, or behavioral maneuvers, akin to “chin tuck,” a technique within which you tuck your chin in order that food and different substances don't enter the trachea when swallowing. If you are unable to swallow safely despite rehabilitation strategies, then medical or surgical intervention could also be necessary for the short-run as you recover. In progressive conditions akin to amyotrophic lateral pathology (ALS, or Lou Gehrig’s disease), a feeding tube within the abdomen could be necessary for the long-term. For a few folks, treatment may involve muscle exercises to strengthen weak facial muscles or to enhance coordination. For others, treatment may involve learning to eat in a special way. For example, some people may need to eat with their head turned to at least one facet or trying straight ahead. getting ready food during a certain manner or avoiding sure foods could facilitate in some situations. For instance, those who cannot swallow skinny liquids might have to add special thickeners to their drinks. Others may need to avoid hot or cold foods or drinks. For some, however, overwhelming enough foods and liquids orally may not be possible. These people should use different strategies to nourish their bodies. Typically this involves a feeding system, akin to a feeding tube, that bypasses or supplements a part of the swallowing mechanism that's not operating normally.
Treatment for dysphagia depends on the type or cause of your swallowing disorder.
Oropharyngeal dysphagia
For cavity dysphagia, your health care supplier may refer you to a speech or swallowing therapist. medical care might include:
Learning exercises. Certain exercises might help coordinate your swallowing muscles or restimulate the nerves that trigger the swallowing reflex.
Learning swallowing techniques. You may conjointly learn ways to put food in your mouth or position your body and head to assist you swallow. Exercises and new swallowing techniques might help if your disorder is caused by medicine issues cherishing Alzheimer' sickness or Parkinson' disease.
Esophageal dysphagia
Treatment approaches for esophageal dysphagia might include:
Esophageal dilation. For a decent musculature sphincter muscle (achalasia) or AN esophageal stricture, your health care supplier may use an medical instrument with a special balloon hooked up to softly stretch and expand your gorge or pass a versatile tube or tubes to stretch the esophagus (dilation).
Surgery. For an esophageal tumor, achalasia or pharyngoesophageal diverticulum, you might need surgery to clear your esophageal path.
Medications. Difficulty swallowing related to GERD is treated with prescription oral medications to scale back abdomen acid. you would possibly ought to take these medications for an extended time. Corticosteroids could be suggested for white blood cell esophagitis. For passage spasm, swish muscle relaxants might help.
Diet. Your health care supplier would possibly visit a special diet to assist together with your symptoms, betting on the explanation for the dysphagia. If you have leukocyte esophagitis, diet may be used as treatment.
Severe dysphagia
If problem swallowing prevents you from ingestion and drinking enough and treatment doesn't enable you to swallow safely, your health care supplier may suggest a feeding tube. A feeding tube provides nutrients while not the necessity to swallow.
Surgery
Surgery can be required to alleviate swallowing issues caused by throat narrowing or blockages, as well as bony outgrowths, vocal fold paralysis, pharyngoesophageal diverticula, GERD and achalasia, or to treat passage cancer. Speech and swallowing medical aid is sometimes useful once surgery. The sort of surgical operation depends on the reason behind dysphagia. Some examples are:
Laparoscopic Heller myotomy. This involves cutting the muscle at the lower finish of the muscular structure (sphincter) once it fails to open and unharness food into the abdomen in those that have achalasia.
Peroral endoscopic myotomy (POEM). The doc or MD uses an medical instrument inserted through the mouth and down the throat to make an incision within the within lining of the passage to treat achalasia Then, as in a very Heller myotomy, the surgeon or gastroenterologist cuts the muscle at the lower finish of the passageway sphincter.
Esophageal dilation. The health care supplier inserts a lighted tube (endoscope) into the muscle system and inflates a connected balloon to stretch it (dilation). This treatment is employed for a good muscle at the tip of the esophagus (achalasia), a narrowing of the esophagus (esophageal stricture), an abnormal ring of tissue settled at the junction of the esophagus and abdomen (Schatzki' ring), and motility disorders. Long versatile tubes of variable diameter conjointly could also be inserted through the mouth into the esophagus to treat strictures and rings.
Stent placement. The health care supplier may insert a metal or plastic tube (stent) to prop open a narrowing or blocked esophagus. Some stents are permanent, admire those for folks with passageway cancer, whereas others are removed later.
OnabotulinumtoxinA. This can be injected into the muscle at the top of the esophagus (sphincter) to cause it to relax, rising swallowing in achalasia. Less invasive than surgery, this method may need repeat injections. additional study is needed.
Lifestyle and home remedies
If you've got hassle swallowing, take care to envision a health care supplier and follow his or her advice. Also, some belongings you will attempt to facilitate ease your symptoms include:
Changing your eating habits. Try to intake smaller, frequent meals. Cut your food into smaller pieces, chew food totally and eat more slowly. If you've got issues swallowing liquids, there are merchandise you'll purchase to thicken liquids.
Try foods with different textures to see if some cause you more trouble. Thin liquids, reminiscent of low and juice, are a retardant for a few people, and sticky foods, such as spread or caramel, will create swallowing difficulty. Avoid foods that cause you trouble.
Limiting alcohol and caffeine. These can dry your mouth and throat, making swallowing more difficult.
Preparing for your appointment
See your health care supplier if you're having issues swallowing. Looking at the suspected cause, your health care provider may refer you to an Associate in Nursing ear, nose and throat specialist, a doctor who specializes in treating organic process disorders (gastroenterologist), or a doctor who specializes in diseases of the systema nervosum (neurologist). Here's some data to assist you in inducting your appointment.
What you can do
When you build the appointment, raise if there's something you wish to try to do in advance, admire and limit your diet.
Make a list of:
Your symptoms, including any that seem unrelated to the reason for which you scheduled the appointment, and when they began
Key personal information, including major stresses or recent life changes
All medications, vitamins and supplements you take, including doses
Questions to ask your healthcare provider
For dysphagia, questions to ask your health care provider include:
What's the likeliest cause of my symptoms?
What are other possible causes?
What tests do I need?
Is this condition temporary or long lasting?
I have other health conditions. How can I best manage them together?
Do I need to restrict my diet?
Are there brochures or other printed material I can have? What websites do you recommend?
What to expect from your doctor
Your health care provider is likely to ask you a number of questions, including:
Have your symptoms been continuous or occasional?
Does anything seem to improve your symptoms?
What, if anything, appears to worsen your symptoms? For example, are certain foods harder to swallow than others?
Do you have difficulty swallowing solids, liquids or both?
Do you cough or gag when you try to swallow?
Did you first have trouble swallowing solids and then develop difficulty swallowing liquids?
Do you bring food back up (regurgitate) after swallowing it?
Do you ever vomit or bring up blood or black material?
Have you lost weight?
What you can do in the meantime
Until your appointment, it'd be easier to chew your food a lot more slowly and totally than usual. If you've got pyrosis or GERD, strive to consume smaller meals and not eat right before bedtime. Antacids that you simply will get while not a prescription conjointly might help temporarily.
General summary
First a doctor will try to find out the cause of the issue and treat it For example if the person has a stroke or cerebral palsy those issues may be treated first If the cause is not immediately apparent doctors may order tests to try to determine what's causing dysphagia These can include an endoscopy in which doctors look inside people's throats with a small camera; X-rays; MRI (magnetic resonance imaging); CT (computed tomography) scans; and/or brain scans If you have dysphagia and your doctor suspects you have another condition causing it (such as throat cancer) he'll probably perform these tests as.