Common Causes
When we have identified that a patient may have a swallowing problem, we should refer them to a Speech Pathologist and other health professionals who will work with you, the patient and their family and carers to inform the development of a comprehensive and consistent assessment and intervention plan.
Related Conditions
Enteral feeding. Esophageal stent placement. Surgery. Treatment for specific swallowing disorders. Medication may be effective for swallowing disorders caused by a neurological or muscular disorder, including: Myasthenia gravis — a neuromuscular disorder that causes weaknesses in certain muscles
When should I refer a patient with a swallowing problem?
Nursing Interventions. Reassure the patient to chew completely, eat gently, and swallow frequently, especially if extra saliva is produced. Give the patient with direction or reinforcement until he or she has swallowed each mouthful.
How do you treat a person with a swallowing disorder?
Your health care provider will likely ask you for a description and history of your swallowing difficulties, perform a physical examination, and use various tests to find the cause of your swallowing problem. X-ray with a contrast material (barium X-ray). You drink a barium solution that coats your esophagus, making it easier to see on X-rays.
What to do if a nursing home patient is having trouble swallowing?
How do I know if I have trouble swallowing?
How do you explain difficulty swallowing?
Dysphagia is difficulty swallowing — taking more time and effort to move food or liquid from your mouth to your stomach. Dysphagia can be painful. In some cases, swallowing is impossible.
How would you support a client with swallowing difficulties?
Be positive about food served. Never make negative comments about the diet and food /drink served in front of the person with dysphagia. Try to encourage the person to do as much for themselves as is safely possible, this will help make swallowing safer. Try to support the person to sit in a stable position.
How do you encourage a patient to swallow?
Encourage slower, smaller bites. Smaller, more frequent meals or snacks throughout the day may help. To ensure swallowing safety, she reminded caregivers to ensure that all food and liquid are swallowed before feeding the next bite.
What can speech therapy do for someone who has difficulty swallowing?
Treatment your speech therapist may provide includes: Exercises for your swallowing muscles to train your muscles to work together to help you swallow. Compensation Strategies: You may also need to learn how to position your body or how to put food in your mouth to be able to swallow better. Changing the foods you eat.
What are three safe swallowing strategies that you have used when supporting people with dysphagia?
Do not gulp drinks. Eat slowly. Chew foods well before swallowing. Make sure you have swallowed your food or drink before taking more.
How can elderly improve their swallowing?
If it turns out that your loved one does suffer from dysphagia, the following tips can help you to manage their condition effectively:Proper Medication Administration. ... Maintain Hydration. ... Avoid Straws. ... Dietary Changes. ... Improved Posture. ... Swallowing Therapy. ... Feeding Tubes. ... Work with a Professional.
What helps with swallowing?
Try eating smaller, more frequent meals. Cut your food into smaller pieces, chew food thoroughly and eat more slowly. If you have difficulty swallowing liquids, there are products you can buy to thicken liquids. Trying foods with different textures to see if some cause you more trouble.
How do speech and language therapists help with swallowing?
Speech and language therapists (SALTs) assess difficulties with swallowing and communication. They can offer support through swallowing and speech exercises, dietary advice and changes to medication. Difficulties in swallowing, known as dysphagia, may arise from a number of medical causes.
What may a speech pathologist do in order to treat compensate for a patient's swallowing disorder?
The patient may also be trained using swallowing strategies such as tucking their chin, alternating solids and liquids during meals, or performing multiple swallows to compensate for the decreased muscle strength.
Does a speech therapy do for swallowing?
You may be referred to a speech and language therapist (SLT) for swallowing therapy. An SLT is trained to work with people with eating or swallowing difficulties. SLTs use a range of techniques that can be tailored for your specific problem, such as teaching you swallowing exercises.
What is the treatment for swallowing disorders?
Treatments for Specific Swallowing Disorders. Certain swallowing disorders have their own specific course of treatment. A myotomy — a surgical procedure during which the esophageal sphincter muscle is cut — is performed to treat many of these conditions.
What kind of doctor can diagnose swallowing disorder?
Specialists, including gastroenterologists, radiologists, ear, nose and throat doctors and speech-language pathologists, examine swallowing X-rays, discuss cases and create personalized treatment plans. Once your doctor diagnoses the exact type of swallowing disorder you have, an individualized treatment plan can begin immediately.
What is esophageal stent placement?
Esophageal Stent Placement. Esophageal stent placement is a procedure that is rarely used. However, Johns Hopkins gastroenterologists are leaders in performing this complex procedure. During an esophageal stent placement, your doctor places a stent (thin tube) in your esophagus to slowly expand the stricture (narrowing).
What is esophageal stenosis?
Esophageal stenosis is the presence of a stricture, or narrowing, in the esophagus. If the stricture progresses, it can cause dysphagia or odynophagia. You can minimize the frequency of the symptoms of esophageal stenosis by:
What is the goal of dilation therapy?
Dilation. The goal of dilation therapy is to increase the size of the swallowing channel. Your doctor will often perform dilation therapy at the same time as an endoscopy. Dilation involves passing an instrument through the endoscope to reach the affected area.
Is neurogenic dysphagia a systemic disease?
Neurogenic dysphagia is often a symptom of systemic (bodywide) disease, so your doctor will want to treat the underlying disease as much as possible. Specifically, in order to move ahead with treatment, the following will be evaluated: The extent of structural, mechanical difficulties in the swallowing channel.
Can Zenker's diverticula be treated?
When food becomes trapped in the pouch, patients sense something is stuck, and this can lead to difficult or painful swallowing. Small Zenker’s diverticula do not require treatment other than periodic X-rays. If treatment is necessary, surgical and endoscopic alternatives are available.
What is the first phase of swallowing?
In the first phase, food or liquid is contained in the mouth by the tongueand palate (oral cavity). This phase is the only one we can control. The second phase begins when the brainmakes the decision to swallow. At this point, a complex series of reflexes begin.
How to increase saliva production?
Periodically suck on Popsicles, ice chips or lemon ice, or drink lemon-flavored water to increase saliva production, which will increase swallowing frequency. Food consistency. Minimize or eliminate foods that are tough to chew and eat more soft foods. Puree food in a blender.
What to do if you cough with thin liquids?
If thin liquids cause you to cough, thicken them with a liquid thickener (your speech pathologist can recommend one for you). You can also substitute thicker liquids for thin ones, such as nectar for juice and cream soup for plain broth. Taking medications. Crush pills and mix them with applesauce or pudding.
Where does food go when it is thrust into the throat?
The food is thrust from the oral cavity into the throat (pharynx). At the same time, two other things happen: A muscular valve at the bottom of the pharynx opens, allowing food to enter the esophagus, and other muscles close the airway (trachea) to prevent food from entering the airways.
Can food stick to the esophagus?
Occasionally, food will stick in the eso phagus for a few seconds (especially solid foods), but will pass spontaneously or can be washed down easily with liquids. But there are a number of symptoms that you should get checked for a possible swallowing problem, including: Frequent choking on food.
Can swallowing problems be managed?
Sometimes, a swallowing problem will resolve itself without treatment. On other occasions, swallowing problems can be managed easily. Complex swallowing problems may require treatment by a specialist or several specialists.
What to do if you swallowed something sharp?
Go to the ER if you swallowed something sharp (like a bone), the food feels like it’s stuck for a while, or you can’t even swallow saliva. You may need to have an endoscopy to remove the obstruction. If you have symptoms of esophageal or stomach cancer, see your doctor immediately.
What causes difficulty swallowing?
Anything that causes irritation, injury, compression, or damage to these components can result in difficulty swallowing. The causes of dysphagia can be categorized as either oropharyngeal or esophageal.
Why does achalasia cause esophageal nerve damage?
Achalasia also prevents the sphincter muscle at the bottom of your esophagus from relaxing normally, which prevents food from emptying into the stomach properly. The condition is caused by damaged esophageal nerve cells, which prevent the muscles of the esophagus from functioning as they should.
How to widen esophagus?
One treatment is a procedure called pneumatic dilation, in which your doctor inserts a balloon in your esophagus and inflates it to widen your esophagus. In some cases, surgery is necessary to cut the end of the esophageal sphincter. 5.
What is the sphincter in the esophagus?
The upper esophagus is composed of a sphincter a bundle of muscles that are important for control of eating and protecting the airway. The lower esophagus also has a sphincter that closes and contracts to prevent acid and stomach contents from going back into the esophagus. Conditions that cause esophageal difficulties in swallowing can be categorized as muscular or structural.
How to diagnose ZD?
Your doctor or gastroenterologist can diagnose ZD with a barium swallow test. In this imaging test, you drink a liquid that allows your doctor to see your esophagus on an X-ray. People with moderate to severe ZD may need surgery, or a diverticulotomy, to break apart the muscles.
Why is it so hard to swallow?
Difficulty swallowing can be caused by something as simple as not chewing your food enough but can also be a sign of serious conditions, such as a stroke or cancer. Fellow, New York Presbyterian Hospital/Columbia.
Key messages
Many conditions can impact on swallowing, so we need to be aware of the signs of swallowing problems and gather information about each patient from them, their family and carers.
Screening patients who present with a stroke
Prompt screening is particularly important after stroke as no food, drink or oral medications should be given to the patient until it is clear there are no swallowing problems. 1
Screening patients with certain medical conditions
Many medical conditions can impact on the normal swallowing process. Finding out whether a person has experienced any difficulty is crucial, particularly with the following conditions:
Gather information from the patient, their family and carers
If we observe any of the signs or symptoms of swallowing difficulties or the patient complains of any of these problems, we should gather further information from the patient and their family and carers, explore the history of these issues, raise the concern with the treating team and work together to mitigate any immediate risks.
What to do if you have difficulty swallowing?
Severe dysphagia. If difficulty swallowing prevents you from eating and drinking adequately, your doctor may recommend: A special liquid diet. This may help you maintain a healthy weight and avoid dehydration. A feeding tube. In severe cases of dysphagia, you may need a feeding tube to bypass the part of your swallowing mechanism ...
How to help someone who is having trouble swallowing?
If you have trouble swallowing, be sure to see a doctor and follow his or her advice. Also, some things you can try to help ease your symptoms include: Changing your eating habits. Try eating smaller, more-frequent meals. Be sure to cut your food into smaller pieces, chew food thoroughly and eat more slowly.
What is the best treatment for throat narrowing?
Surgery. Surgery may be recommended to relieve swallowing problems caused by throat narrowing or blockages, including bony outgrowths, vocal cord paralysis, pharyngoesophageal diverticulum, GERD and achalasia, or to treat esophageal cancer. Speech and swallowing therapy is usually helpful after surgery.
How to treat esophageal dysphagia?
For a tight esophageal sphincter (achalasia) or an esophageal stricture, your doctor may use an endoscope with a special balloon attached to gently stretch and expand the width of your esophagus or pass a flexible tube or tubes to stretch ...
What is the treatment for oropharyngeal dysphagia?
Oropharyngeal dysphagia. For oropharyngeal dysphagia, your doctor may refer you to a speech or swallowing therapist, and therapy may include: Learning exercises. Certain exercises may help coordinate your swallowing muscles or restimulate the nerves that trigger the swallowing reflex. Learning swallowing techniques.
How to help with dysphagia?
Learning swallowing techniques. You may also learn ways to place food in your mouth or to position your body and head to help you swallow. You may be taught exercises and new swallowing techniques to help compensate for dysphagia caused by neurological problems such as Alzheimer's disease or Parkinson's disease.
What type of surgery is used to treat dysphagia?
The type of surgical treatment depends on the cause for dysphagia. Some examples are: Laparoscopic Heller myotomy, which is used to cut the muscle at the lower end of the esophagus (sphincter) when it fails to open and release food into the stomach in people who have achalasia. Peroral endoscopic myotomy (POEM).
What to do if you can't swallow?
If patient has impaired swallowing, do not feed until an appropriate diagnostic workup is completed. Ensure proper nutrition by consulting with physician for enteral feedings, preferably a PEG tube in most cases . Feeding a patient who cannot sufficiently swallow results in aspiration and possibly death.
How to improve swallowing ability?
Discuss the importance of exercise to enhance the muscular strength of the face and tongue to enhance swallowing. Muscle strengthening can facilitate greater chewing ability and positioning of food in the mouth. Educate patient, family, and all caregivers about rationales for food consistency and choices.
What is the best team for impaired swallowing?
For impaired swallowing, use a dysphagia team composed of a rehabilitation nurse, speech pathologist, dietitian, physician, and radiologist who work together. The dysphagia team can help the patient learn to swallow safely and maintain a good nutritional status. Place suction equipment at the bedside, and suction as needed.
What is impaired swallowing in nursing?
Impaired swallowing involves more time and effort to transfer food or liquid from the mouth to the stomach. It occurs when the muscles and nerves that help move food through the throat and esophagus are not working right.
Why does my swallowing muscle become weak?
The swallowing muscles can become weak with age or inactivity.
How long does it take to see a speech pathologist after a CVA?
Ensure that patient is seen by a speech pathologist within 72 hours after admission if patient has had a CVA.
What to give a patient before feeding?
Before feeding, provide the patient a lemon wedge, pickle, or tart-flavored hard candy. Use artificial saliva. Moistening and use of tart flavors stimulate salivation, lubricate food, and improves the ability to swallow. If patient has an intact swallowing reflex, attempt to feed.
What is swallowing problem?
A swallowing problem may be a symptom of an underlying problem. Your healthcare provider will take a full health history and give you a physical exam. Your provider may also order tests, including: An endoscopy. This test is done by a gastroenterologist, a healthcare provider who specializes in the digestive tract.
What are the risks of swallowing?
Risk factors for swallowing problems include chronic conditions such as Parkinson disease, Alzheimer disease, a stroke, GERD, or allergies. Other risk factors include damage to your esophagus from a tracheotomy, throat surgery, or radiation treatment.
How to stop swallowing if you have GERD?
If your problems stem from GERD, try taking antacids to control your acid reflux symptoms . Prop up the head of your bed.
Why is it so hard to swallow?
In rare cases, swallowing problems are tied to a serious illness. For example, a stroke, Parkinson disease, or late-stage Alzheimer disease can make it hard to swallow and possibly lead to choking.
What is a X-ray taken while you swallow?
For this test, X-rays are taken while you swallow a barium solution. Sometimes a video is made while you swallow different liquids, with a specially trained swallow therapist nearby. Motility testing. This may be done to see if your esophagus is contracting and relaxing in the right way.
What does it feel like to have a lump in your throat?
Feeling of a lump in your throat. Hoarseness. Feeling that food or liquid is stuck in your throat or behind your breastbone. Pain or tightness in your throat or chest. Weight loss or not getting the nutrition you need because of trouble swallowing.
Can swallowing problems be caused by serious problems?
If you have trouble swallowing, it's important to see your healthcare provider. Sometimes, swallowing difficulties may be caused by serious problems.