Dysphagia: What's Behind Your Swallowing Difficulties?
Grace Weatherby
/ Categories: WELLNESS, 2024

Dysphagia: What's Behind Your Swallowing Difficulties?

Swallowing is a complex process that involves the coordinated action of at least 30 muscles and multiple nerves in the mouth, throat, and esophagus. When any part of this system is disrupted, it can lead to swallowing difficulties, also known as dysphagia.

More prevalent in older adults, dysphagia can prove to be a minor inconvenience for some while for others it can lead to severe complications and put their health and quality of life at risk.

Dysphagia can present a variety of symptoms, broadly categorized into two types: oropharyngeal and esophageal. The type of symptoms being experienced serve as clues to medical professionals about the potential cause of the condition.

Here’s how the symptoms of oropharyngeal and esophageal dysphagia differ:

Oropharyngeal Dysphagia:

  1. Difficulty starting to swallow: This includes trouble moving food from the mouth to the throat.
  2. Choking or coughing: Food or liquids might enter the airway instead of the esophagus, causing coughing or choking.
  3. Nasal regurgitation: Liquids or food coming back up through the nose.
  4. Gurgling voice: A wet-sounding voice after eating or drinking.
  5. Recurrent pneumonia: Due to aspiration of food or liquids into the lungs.

Esophageal Dysphagia:

  1. Feeling of food stuck in the throat or chest: A sensation that food is lodged somewhere in the esophagus.
  2. Painful swallowing: Discomfort or pain when swallowing.
  3. Regurgitation: Bringing food back up without nausea.
  4. Heartburn: A burning sensation in the chest.
  5. Unexplained weight loss: Difficulty in swallowing may lead to a reduced intake of food, resulting in weight loss.

With a clear understanding of the type of dysphagia you’re experiencing, your healthcare provider can begin to explore what’s specifically behind your condition.

COMMON CAUSES OF DYSPHAGIA

Oropharyngeal

Aging

Head and neck surgeries and injuries

Dementia

Stroke  

Parkinson’s Disease

Amyotrophic Lateral Sclerosis (ALS)

Multiple Sclerosis (MS)

Muscular Dystrophy

Thyroid Enlargement: Often the result of an iodine deficiency or Grave’s Disease

Pharyngitis and Tonsillitis: Inflammation of the throat and tonsils most often due to infection

Oral Candidiasis (Thrush): Soreness in the mouth and throat resulting from a fungal infection in the mouth

Esophageal

Aging

Esophageal Stricture: A narrowing of the esophagus, often the result of acid reflux of gastroesophageal reflux disease (GERD)

Esophageal Rings and Webs: Thin layers of tissue that form in and partially block the esophagus. These can be congenital or develop later due to chronic acid exposure from GERD.

Esophageal Tumors: Benign or malignant growths in the esophagus. Risk factors include smoking, heavy alcohol use, and family history.

Diffuse Esophageal Spasm: Irregular spasm contractions of the esophagus brought on by damage to the nerves that coordinate the muscles of the esophagus

Scleroderma: Hardening and tightening of the skin and connective tissues that restricts the esophagus, resulting from an autoimmune disease

Eosinophilic Esophagitis: An allergic inflammatory condition often related to food allergies and environmental allergens

 

Understanding the type of dysphagia you are experiencing and the underlying cause is crucial for effective treatment and management.

Beyond assessing your symptoms, diagnosis often involves a clinical examination and imaging studies. Based on the findings, treatment may include:

  • Swallowing therapy: Exercises to strengthen the muscles involved in swallowing
  • Lifestyle changes: Modifying eating habits and using safe swallowing strategies
  • Dietary modifications: Changing the texture of foods and liquids to make swallowing easier and/or reducing acid intake.  
  • Medications: To manage underlying conditions like infections or inflammation.
  • Surgery: In cases where structural abnormalities need to be corrected.
  • Dilation: Stretching narrowed areas of the esophagus.

If you or someone you know experiences persistent difficulty swallowing, contact your doctor. Addressing any issue early can significantly improve outcomes and help you return to living your life fully sooner.

 

Kate O'Neill, MS, CCC-SLP, is a speech-language pathologist at SVMC Outpatient Rehabilitation, part of Southwestern Vermont Medical Center.

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SVMC Creates Virtual Waiting Room to Encourage Distancing

BENNINGTON, VT—May 29, 2020—Starting Monday, many people who need in-person appointments at Southwestern Vermont Health Care's (SVHC) hospital and clinics will no longer need to use traditional waiting rooms. A virtual system created by the hospital allows patients to call 802-447-5000 when they arrive in the parking lot and receive a text message when their provider is ready to see them.

SVMC's outpatient and inpatient surgeries and diagnostic services, like those for imaging and laboratory work, have resumed with enhanced safety protocols per the directive of Governor Phil Scott. The health system's emergency department, ExpressCare, emergency surgical services, and most of its primary and specialty practices remained open during the pandemic.

"SVHC has provided safe, high-quality care throughout the pandemic." Said Thomas A. Dee, FACHE, Southwestern Vermont Health Care’s (SVHC) president and CEO. "Innovation has been an important part of providing care during these extraordinary times and this new program decreases the number of people in our waiting rooms and allows them to stay the recommended 6 feet apart or more."

In order to use the virtual waiting room, patients must be able to wait in their vehicle and have a charged cell phone with them. They will receive the virtual waiting room telephone number during their appointment-reminder telephone call. Signs outside the building and at the respiratory check-in stations inside the main hospital and medical office building entrances will also include the number to call.

Patients simply call the number when they arrive in the parking lot and wait in their cars. When the provider is ready to see them, they will receive a text message alert to indicate that they should come in.

"We love that we can use the same technology that most people carry with them to help people stay socially distanced," said Gail Balch, RN, who directs information technology at SVMC. "It's through innovations like this one that we are able to resume services safely and ensure patients receive the care they need."

Hospital and clinic staff anticipate that the new program will allow greater distance between people who must use traditional waiting rooms, including those who walked or took public transportation to their appointment and those who do not have a cell phone.

Additional safety protocols indicate that all patients should arrive to the hospital or clinic with their own cloth face covering. Face coverings must be worn over the mouth and nose for the entire duration of patients' visits. Patients should also come alone, unless they absolutely need assistance from a loved one.

For questions about how to resume or initiate elective care, call your primary care provider or the specialist directly. For a list of providers, visit svhealthcare.org/physician-directory.

Patients with cough or shortness of breath or any two of the following—fever, chills, muscle pain, headache, sore throat, or new loss of taste or smell—should contact their primary care provider or the COVID-19 Informational Hotline at 802-440-8844 before arriving to either their provider’s office or the hospital. For a detailed list of safety protocols, frequently asked questions, visitor guidelines, and COVID-19 information, visit svhealthcare.org.

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