Swallowing is a function we often take for granted. However, for many people, this natural function becomes a challenge. A swallowing disorder, known as dysphagia, can significantly impact daily life. It frequently occurs after neurological conditions such as a stroke, as well as in neurodegenerative diseases like Parkinson’s.
In this article, we aim to provide an overview of what a swallowing disorder is, what causes it, and how we treat dysphagia in our clinic.
What is a Swallowing Disorder (Dysphagia)?
Dysphagia refers to a disturbance in the swallowing process. Normally, swallowing occurs effortlessly and unconsciously, but it can be disrupted by neurological impairments. This involves multiple muscle groups working together to transport food and liquid safely from the mouth to the stomach. Affected individuals may struggle to consume food or liquids. The swallowing process can become uncertain, intermittent, or even dangerous if liquids or food enter the airways, potentially causing obstruction.
What are the Causes of Dysphagia?
The swallowing process is a finely tuned interplay of muscles and nerves in the oral and pharyngeal regions. Disruptions in this system can lead to difficulties in adequately chewing or swallowing food safely. The causes of swallowing disorders are varied. They often arise as a result of neurological diseases, such as:
- Strokes: One of the most common causes of dysphagia, as the coordination of the muscles and the associated nerves responsible for swallowing can be impaired or completely damaged by brain injuries.
- Neurodegenerative Diseases: Conditions like Parkinson’s or multiple sclerosis affect muscle control, including the muscles responsible for swallowing, which can lead to swallowing difficulties.
Symptoms and Diagnosis of Swallowing Disorders
Swallowing disorders often manifest as the sensation of food or liquid being stuck in the throat, frequent choking, coughing during or after eating, and recurrent pneumonia.
Diagnosis is conducted by our speech therapists through specialized tests such as the fiberoptic endoscopic evaluation of swallowing (FEES). This allows for a visual inspection of the anatomy and function of the swallowing process, particularly the pharynx and larynx.
Risks of Untreated Swallowing Disorders
The greatest risk associated with dysphagia is aspiration, meaning that food or liquid enters the airways. Depending on the extent, this can lead to pneumonia or life-threatening airway obstruction. Additionally, malnutrition and dehydration are common consequences, as affected individuals often eat and drink less to avoid swallowing difficulties.
Treatment of Dysphagia
In our clinic, we work in an interdisciplinary team to diagnose and treat affected individuals early on to fully restore or improve their swallowing ability.
Speech therapy is central to our approach. Through specialized exercises, we specifically train the muscles responsible for swallowing and help patients manage their swallowing disorder more safely.
Adjusting the diet is also a crucial part of treatment. Our nutritionists determine, based on the IDDSI levels (International Dysphagia Diet Standardisation Initiative), the consistency of food that patients need. Depending on the severity of the swallowing disorder, it may be necessary to thicken or puree food and liquids to facilitate swallowing and reduce the risk of choking. In more severe cases, when oral intake is significantly restricted, temporary feeding through a gastric tube may be required.
