What is dysphagia?

Dysphagia refers to difficulty in swallowing.  When the muscles and nerves used for swallowing are weakened or damaged, the patient might experience difficulty eating and drinking.  For patients with dysphagia, food or fluids might enter the lungs (aspiration), which can cause a serious lung infection. Patients with swallowing difficulty might also be at risk of malnutrition and dehydration.

What causes dysphagia?

Common conditions causing dysphagia includes: stroke, neurological disorders e.g. Parkinson’s Disease, dementia, head and neck cancers and respiratory conditions e.g. Chonic Obstructive Pulmonary Disease

What are some signs or symptoms of dysphagia?

• Drooling
• Difficulty initiating swallowing
• Coughing, choking, throat clearing when eating or drinking
• Wet gurgly voice before or after swallowing
• Feeling food stuck in pharynx or upper oesophagus

How can we help?

Assessment:

We will conduct a thorough swallowing assessment to determine the cause of the difficulty.  Diagnostic tools may be used to facilitate accurate assessment and diagnosis and to aid swallowing rehabilitation.

These include

• Videofluroscopy (VFS) which is a swallowing X-Ray that is taken while patient is swallowing food and fluids.
• Fiberoptic Endoscopic Evaluation of Swallowing (FEES) whereby an endoscope is used to look into the larynx when swallowing food and fluids. 

Intervention:

1)     Modifying diet textures and liquid consistency

Some patients will need to thicken their fluids.  The Speech Therapist will recommend the most suitable consistency of fluids and diet textures to ensure safe swallowing. 

2)     Safe feeding techniques

e.g. Spoon feeding instead of cup or straw drinking.

3)     Postural Manoeuvres

Techniques such as Chin Tuck strategy to reduce aspiration risk when swallowing.

4)     Caregiver Training

To ensure carers are confident and competent in managing feeding for the patient.

Rehabilitation:

1)     Thermal tactile stimulation

A sensory technique to stimulate and speed up the swallow reflex

2)     Swallow Strengthening exercises

Targeting the weak oral, laryngeal or pharyngeal muscles used for chewing and swallowing

3)     Vitalstim Therapy

Unites the power of neuromuscular electrical stimulation with the benefits of swallowing exercises.

How effective are speech-language pathology treatments for dysphagia?

American Speech-Language-Hearing Association (ASHA) produced a treatment efficacy summary on dysphagia [http://www.asha.org/uploadedFiles/public/TESDysphagiainAdults.pdf] that describes evidence about how well treatment works.

Eating and drinking is extremely important for quality of life. Patients with severe swallowing difficulties might feel frustrated or depressed. We believe that early intervention with the right therapy and good family support is crucial to our client’s recovery.