Swallowing disorders. How to solve ?
Written by:The doctor. Carlos Pollán and the Dra. Jennifer Knäpper is part of the Dr Otolaryngology Unit. Jordi Coromina. They are responsible for the Dysphagia Unit (disorders of swallowing) at the Quirón Teknon Hospital in Barcelona.
Swallowing is the passage of food from the mouth into the esophagus. It involves a rapid coordination of the involved structures ( mouth, pharynx, larynx and upper part of the esophagus ), whose movements are directed by the nervous system.
When there is difficulty swallowing a solid or liquid we say that the patient has a swallowing disorder or dysphagia .
What are the causes?
There are many diseases that can cause an alteration of swallowing. For example, those of the nervous system, which acts as the coordinator of the process: stroke (stroke), dementia, Parkinson's , infantile cerebral palsy, multiple sclerosis , and traumatic brain injury (usually due to traffic accidents).. On other occasions the problem will be in the oral cavity (absence of dental pieces, tongue changes, tumors ), or in the esophagus.
How are swallowing disorders diagnosed?
In the first place, good questioning of the patient is essential, or, in the case of children or adults with communication difficulties, with their relatives.
Next, we will perform in the same consultation, an endoscopy , a quick and painless test, which will allow us to perfectly visualize the mouth, the pharynx and the entrance of the esophagus.. If after the endoscopy we suspect that the cause is in other areas of the digestive system, we will coordinate the case with the corresponding specialist (gastroenterologist and / or digestive endoscopist).
During the visit, the otolaryngologist will ask the patient about the discomfort he has when swallowing, when he began to notice the symptoms, and if these have worsened over time. It will be important to detect if there is a cough, stagnation of food, need to perform several swallows, drooling, chewing problems, or suffocation and choking during swallowing.
After the interrogation and endoscopy, we will perform the so-called " Dysphagia test ", which consists of asking the patient to eat different foods, first liquids and then solids, while watching on a video screen how to swallow them, thus identifying the cause of the problem. We will observe what kind of food, what viscosity, what volume and what position are safer so that the patient can swallow correctly.
Do you have treatment?
Yes. Logically, the treatment will depend on the cause and age of the patient (child or adult). According to the explorations made, an adaptation of the diet will be made individually, in collaboration with a nutrition specialist.
In addition, rehabilitation treatment will be necessary, together with a swallowing specialist speech therapist, with postural changes and specific swallowing maneuvers.
Early diagnosis and treatment will prevent various complications such as malnutrition, dehydration and aspiration pneumonia.
