What evidence is used to select treatment options for dysphagia?
Treatment options for patients with dysphagia are selected on the basis of evidence-based practice, which includes a combination of the best available internal and external evidence. This includes external scientific research as well as data gathered on a specific person. Internal and external evidence may come from the clinician’s experience.
How should oropharyngeal dysphagia be differentiated from esophageal dysphagia?
Oropharyngeal dysphagia should be differentiated from esophageal dysphagia. Each should be considered as a distinct category. While medical history and clinical examination are essential for making such a differentiation, investigations are helpful in identifying the underlying cause under each of these two categories.
What does dysphagia mean in nursing?
Introduction Dysphagia is defined as objective impairment or difficulty in swallowing, resulting in an abnormal delay in the transit of a liquid or solid bolus. The delay may be during the oropharyngeal or esophageal phase of swallowing.
Why choose a speech-language pathologist for dysphagia?
Dysphagia may increase caregiver costs and burden and may require significant lifestyle alterations for the patient and the patient’s family. Speech-language pathologists (SLPs) are the preferred providers of dysphagia services and are integral members of an interprofessional team to diagnose and manage oral and pharyngeal dysphagia.
What is the most common cause of pharyngeal dysphagia?
Pharyngeal dysphagia — the problem is in the throat. Issues in the throat are often caused by a neurological problem that affects the nerves (such as Parkinson's disease, stroke, or amyotrophic lateral sclerosis).
What happens in pharyngeal phase dysphagia?
During this phase, called the pharyngeal phase, the larynx (voice box) closes tightly and breathing stops to prevent food or liquid from entering the airway and lungs.
What medications have dysphagia as a side effect?
Drug classes that may contribute to difficulty swallowing include neuroleptics, chemotherapy agents, antihypertensives, tricyclic antidepressants, anticholinergics, antihistamines, antiparkinsonian agents, and other drugs that impair saliva production.
What causes dysphagia oropharyngeal phase?
Oropharyngeal dysphagia can commonly result from muscle weakness. Additionally, a person may have reduced ability to feel food, liquid or saliva that remains in the mouth or throat after swallowing. In some cases, an individual may not be able to feel food, liquid or saliva entering the windpipe (called aspiration).
What are signs of pharyngeal dysphagia?
Signs and symptoms of oral or pharyngeal dysphagia include the following:Coughing or choking with swallowing.Difficulty initiating swallowing.Food sticking in the throat.Sialorrhea.Unexplained weight loss.Change in dietary habits.Recurrent pneumonia.Change in voice or speech (wet voice)More items...•
What happens pharyngeal phase?
During the pharyngeal phase, the tongue seals the oropharynx. The soft palate and proximal pharyngeal wall seal off the nasopharynx. The vocal cords and arytenoids close off the laryngeal opening and the epiglottis swings down to cover the laryngeal vestibule. These actions seal the airway from the pharyngeal cavity.
Do antibiotics cause dysphagia?
They depress the nervous system functions, and thus can increase the risk for dysphagia. Anti-psychotics and neuroleptics can cause movement disorders or dyskinesias. Antibiotics can also cause esophogitis, glossitis, or fungal infections.
What causes dysphagia?
Dysphagia is usually caused by another health condition, such as: a condition that affects the nervous system, such as a stroke, head injury, multiple sclerosis or dementia. cancer – such as mouth cancer or oesophageal cancer. gastro-oesophageal reflux disease (GORD) – where stomach acid leaks back up into the ...
Can antibiotics cause difficulty swallowing?
Antibiotics: One of the most common causes of drug-induced esophagitis. These include tetracyclines, especially doxycycline. Other antibiotics that can cause esophagitis include clindamycin, amoxicillin, metronidazole, ciprofloxacin, rifaximin, etc.
What is the treatment for oropharyngeal dysphagia?
For oropharyngeal dysphagia, your health care provider might refer you to a speech or swallowing therapist. Therapy might include: Learning exercises. Certain exercises might help coordinate your swallowing muscles or restimulate the nerves that trigger the swallowing reflex.
Which of the following are causes of esophageal dysphagia?
Some of the causes of esophageal dysphagia include:Achalasia. ... Diffuse spasm. ... Esophageal stricture. ... Esophageal tumors. ... Foreign bodies. ... Esophageal ring. ... GERD . ... Eosinophilic esophagitis.More items...•
Which of the following is a symptom of dysphagia difficulty swallowing?
Dysphagia is the medical term for difficulty in swallowing. This includes problems with sucking, swallowing, drinking, chewing, eating, dribbling saliva, closing lips, or when food or drink goes down the wrong way. Early signs of dysphagia are coughing, gagging or choking while eating and drinking.
What are the complications of dysphagia?
One of the most common complications is coughing or choking when food goes down the "wrong way" and blocks your airway. This can lead to chest infections, such as aspiration pneumonia, which requires urgent medical treatment.
What is the diagnosis of oropharyngeal dysphagia?
Diagnosis. Treatment. Complications. Oropharyngeal dysphagia refers to a disorder in which you cannot properly swallow food, liquid or saliva. This is a serious condition and it is essential that you seek medical care if you experience difficulty swallowing. Read on to find out more about the signs, causes, and treatment for oropharyngeal dysphagia.
What is swallowing disorder?
Dysphagia or swallowing disorder is characterized by the dysfunction of one or more parts of the swallowing apparatus. 1 . The swallowing apparatus begins with the mouth and includes the: In oropharyngeal dysphagia, you have trouble moving food, liquid, or saliva from your mouth into your throat.
What are the parts of the swallowing apparatus?
The swallowing apparatus begins with the mouth and includes the: 1 Lips 2 Tongue 3 Oral cavity 4 Pharynx (throat) 5 Airway 6 Esophagus and its sphincters
What causes dysphagia in the brain?
Some neurological causes of dysphagia include: A stroke. Dysphagia occurs in over 50% of patients with an acute stroke. 6 . Many patients with neurological conditions that cause damage to ...
How do you know if you have difficulty swallowing?
When you have difficulty swallowing, you may be experiencing one or more of the following symptoms: 2 . Increased effort to move food and liquids from the mouth into the upper throat (pharynx). Increased effort or resistance moving food from the upper throat (pharynx) into the lower throat (esophagus).
Is dysphagia dangerous?
Dysphagia can be dangerous, and getting an accurate diagnosis is essential. Your doctor may refer you to an ear, nose, and throat (ENT) doctor or a gastroenterologist (GI). You may also be referred to a speech-language pathologist (SLP) who is a specialist in dysphagia and swallowing management.
What are the consequences of dysphagia?
Moreover, malnutrition and aspiration pneumonia are the most common and troublesome consequences of dysphagia, with increased risk of death in elderly and debilitated patients. Especially, aspiration pneumonia is the most common cause of mortality in patients with neurological disease associated to dysphagia [18].
What is neurogenic dysphagia?
Neurogenic dysphagia is typically occurring in patients with neurological disease of different etiologies. A correct and early diagnosis and an appropriate management of dysphagia could be useful for improving patient’s quality of life and may help to prevent or delay death.
What is the cause of dysphagia in solids?
Theoretically, dysphagia for solids suggests mechanical obstruction caused by diseases involving the esophagus or the base of the tongue (e.g., cancer or lymphoma).
How common is dysphagia in MS?
Dysphagia in multiple sclerosis (MS) occurs in 31.3%. Dysphagia is common in dementia with prevalence rates varying from 13 to 57%. Dysphagia is reported to be prevalent in 30–100% of individuals depending on type of motor neuron disease (MND) and the stage of disease affecting all individuals in the later stages of the disease.
How many pairs of striated cranial muscles are excited and/or inhibited sequentially allowing the
About 50 pairs of striated cranial muscles are excited and/or inhibited sequentially allowing the bolus transit from the mouth to the stomach. Dysphagia is defined as an impairment of this complex and integrated sensorimotor system. Neurogenic dysphagia (ND) is typically occurring in patients with neurological disease of different etiologies ...
What muscles are involved in deglutition?
There are several groups of muscles of deglutition that can be studied in detail: (1) jaw and perioral muscles; (2) submandibular/suprahyoid (SM) muscles; (3) tongue muscles; (4) laryngeal and pharyngeal muscles; and (5) cricopharyngeal (CP) muscle of the upper esophageal sphincter (UES).
What is the purpose of swallowing?
Swallowing is defined as the semiautomatic motor action of the muscles of respiratory, oropharyngeal, and gastrointestinal tract that propels the food from oral cavity to the stomach and protects airway from food, liquids, and other substances.
What are the consequences of dysphagia?
Consequences of dysphagia include malnutrition and dehydration, aspiration pneumonia, compromised general health, chronic lung disease, choking, and even death. Adults with dysphagia may also experience disinterest, reduced enjoyment, embarrassment, and/or isolation related to eating or drinking.
What causes dysphagia in the neck?
Dysphagia may also occur from problems affecting the head and neck, including. cancer in the oral cavity, pharynx, nasopharynx, or esophagus; radiation and/or chemoradiation for head and neck cancer treatment; trauma or surgery involving the head and neck; decayed or missing teeth; and.
What is the term for food or liquid remaining in the oral cavity after swallowing?
food or liquid remaining in the oral cavity after the swallow (oral residue ); inability to maintain lip closure, leading to food and/or liquids leaking from the oral cavity (anterior loss of bolus); extra time needed to chew or swallow; food and/or liquids leaking from the nasal cavity (nasopharyngeal regurgitation);
What is the American Board of Swallowing and Swallowing Disorders?
The American Board of Swallowing and Swallowing Disorders, under the auspices of ASHA’s specialty certification program, offers clinical specialty certification in swallowing and swallowing disorders . Specialty certification is a voluntary program and is not required by ASHA to practice in any disorder area.
What Is Oropharyngeal Dysphagia?
Causes
- There are many different potential causes of dysphagia, ranging from aging to neurological disorders and cancers.6 Identifying the underlying cause of dysphagia is important as it can lead to better treatment selection. In some cases, there can be multiple causes that combine to cause dysphagia.
Diagnosis
- The diagnosis of oropharyngeal dysphagia is made using the assistance of a speech-language pathologist. Specific tests—such as a swallow test—can evaluate the function of the oropharynx and determine if swallowing is impaired. In addition, specialized video cameras called endoscopes can be used to examine swallow function.11 In some cases, imaging tests, such a…
Treatment
- The treatment of oropharyngeal dysphagia varies depending on the specific cause. In the cases where specific causes are identified, treatment of the underlying cause is the first step.12 For example, if cancer is impacting the ability to swallow, then initiating treatment for the cancer is necessary. In addition, certain changes may need to be made to diet and lifestyle to avoid compl…
Complications
- One of the most significant complications from dysphagia is aspiration pneumonia, where abnormal swallowing leads to food or liquid entering the lungs.16 The food and liquid can lead to an infection in the lungs, or pneumonia developing, which is a severe medical complication. Additionally, dysphagia that is ongoing for a long period of time can le...
Summary
- Oropharyngeal dysphagia causes you to lose the ability to swallow. This is a serious medical condition that can be treated in numerous ways, depending on the underlying cause.
A Word from Verywell
- Losing the ability to swallow properly can make you feel at a loss. Swallowing is something that we don’t often think about but is critical to our well-being. Know there are many treatments, exercises, and lifestyle changes available to help manage dysphagia. With appropriate help, you can look to get past dysphagia and live a healthy, fulfilling life.