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7 Facts You Might Not Know About Dysphagia

Close-up photo of an elderly woman holding a mug of tea on her lap

As one of the most commonly diagnosed swallowing disorders, dysphagia affects approximately 10 million Americans.1  In fact, one in 17 men and women in the U.S. will experience some form of dysphagia in their lifetime and nearly half of people over age 60 will be affected by the disorder.2 Typically the result of a neurological disorder or other physical problem, dysphagia damages the nerves and muscles involved in the swallowing process. If you or a loved one has been diagnosed with this disorder, it may help to understand some of the root causes of this condition as they relate to your specific situation.

1. Dysphagia: A Literal Definition

The term “dysphagia” comes from the Greek root word dys which means “difficulty or disordered”, and phagia meaning “to eat”.3

2. Two Types Of Dysphagia

Oropharyngeal dysphagia (high dysphagia) – A problem in the mouth and/or throat. This is usually caused by a neurological problem which causes issues with the nerves (and muscles). Doctors say this type of dysphagia is more difficult to treat4

Esophageal dysphagia (low dysphagia) – A problem in the esophagus. This is usually because of some blockage or irritation. Often, a surgical procedure is required to solve the problem4

3. Typical Signs And Symptoms Of Dysphagia

  • Choking when eating
  • Coughing or gagging when swallowing
  • Drooling
  • Food or stomach acid backing up into the throat
  • Recurrent heartburn
  • Hoarseness
  • Pain while swallowing
  • Sensation of food getting stuck in the throat or chest, or behind the breastbone
  • Unexplained weight loss
  • Bringing food back up (regurgitation)
  • Difficulty controlling food in the mouth
  • Difficulty initiating swallowing (gulping action)
  • Recurrent pneumonia
  • Inability to control saliva in the mouth5

4. Causes Of Dysphagia

Some general causes of dysphagia include:

Damage to the nervous system, such as:

  • Stroke
  • Brain injury
  • Spinal cord injury
  • Parkinson’s disease
  • Multiple sclerosis
  • Amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease)
  • Muscular dystrophy
  • Cerebral palsy
  • Alzheimer’s disease

Problems affecting the head and neck, including:

  • Cancer in the mouth, throat, or esophagus
  • Injury or surgery involving the head and neck
  • Decayed or missing teeth, or poorly fitting dentures6

5. Challenges Of Dysphagia

People with swallowing disorders may experience:

  • Poor nutrition or dehydration
  • Risk of aspiration (food or liquid entering the airway), which can lead to pneumonia and chronic lung disease
  • Lessened enjoyment of eating or drinking
  • Embarrassment or isolation in social situations involving eating7

6. Diagnosing Dysphgaia

Your health care professional may apply one or more of the following testing methods to determine the severity of your swallowing disorder:

  • Take a careful history of medical conditions and symptoms
  • Examine 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 screen8

7. General Treatments For Dysphagia

While treatment depends on the cause, symptoms, and type of swallowing problem, a speech-language pathologist (SLP) 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, such as thickened liquids and pureed foods9

Empower Yourself With Information

While a dysphagia diagnosis for you or a loved one may seem overwhelming, gathering as much information as possible will help you to build peace of mind. Use these seven facts to start on a path of discovery that will lead to the healthiest possible outcomes.

  1. Domench, E., & Kelly, J. (1999, January). Swallowing disorders. Medical Clinics of North America, 83 (1): 97-113.
  2. Ibid.
  3. Effect of dysphagia on patients with Parkinson’s Disease. (2013 Parkinson’s Disease Guide)
  4. What causes dysphagia? Christian Nordqvist, 2010, Medical News)
  5. Disease and conditions: Dysphagia. 2009, Mayo Clinic Staff
  6. Causes of difficulty in swallowing. 2008, George Krucik, MD, MBA
  7. American Speech-Language-Hearing Association. (2001b). Knowledge and skills for speech-language pathologists providing services to individuals with swallowing and feeding disorders in press. In Rockville, MD: Author.
  8. American Speech-Language-Hearing Association. (1992). Position statement and guidelines for instrumental diagnostic procedures for swallowing. Asha, 34(Suppl. 7), 25–33.
  9. ASHA Special Interest Division 13, Swallowing and Swallowing Disorders (Dysphagia). (1997). Graduate curriculum on swallowing and swallowing disorders (adult and pediatric dysphagia). ASHA Desk Reference, 3, 248a–248n.

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