Dysphagia

Swallowing happens in three stages. An individual can have a problem in one, or more of these phases.

They include:

• Oral phase (mouth) – Chewing, sucking, and moving food or liquid around the mouth and into the throat.

• Pharyngeal phase (throat) – Starting, or initiating a swallow and squeezing food down the throat. The airway must be closed off to prevent food or liquid from getting out. Food going into the airway can cause coughing and choking, or can even cause pneumonia in some individuals.

• Esophageal phase – This involves the opening and closing of the esophagus (the tube that goes from the back of the throat to the stomach). The esophagus squeezes food down to the stomach. Food can get stuck in the esophagus. Problems with the esophagus may result in frequent vomiting or acid reflux (also known as indigestion or heartburn).

The symptoms of dysphagia can vary widely and may include:

• Difficulty Initiating Swallowing

Individuals may find it challenging to start the swallowing process, leading to prolonged chewing or difficulty initiating the movement of food or liquids into the throat.

• Coughing or Choking During or After Swallowing

Inability to manage the passage of food or liquids can result in coughing, choking, or a sensation of aspiration, where substances enter the airway.

• Pain or Discomfort

Swallowing may be accompanied by pain or discomfort, either in the throat or chest, indicating potential structural issues or inflammation.

• Unintentional Weight Loss

Dysphagia can lead to reduced food intake, resulting in unintended weight loss and nutritional deficiencies.

• Recurrent Respiratory Infections

Aspiration of food or liquids into the lungs can increase the risk of respiratory infections, such as pneumonia.

• Having Food or Liquid Leak Out of Your Mouth

An individual with dysphagia may notice that food or drink tends to spill out of your mouth unintentionally, especially during meals.

• Clearing Your Throat Often After Eating or Drinking

People with dysphagia may frequently clear their throat after eating or drinking as a way of trying to manage any discomfort or lingering sensations.

• Having a Wet or Gurgly Voice During or After Eating or Drinking

If your voice sounds wet or gurgly while eating or afterward, it could be a sign of dysphagia, indicating difficulty managing saliva or liquids during the swallowing process.

• Feeling Like Something is Stuck in Your Throat or Chest After Eating or Drinking

An individual with dysphagia may experience a sensation of something being stuck in their throat or chest after meals, which can be uncomfortable and worrisome.

• Needing Extra Work or Time to Chew or Swallow

Dysphagia can make eating a bit more challenging, requiring extra effort and time to chew food thoroughly or swallow it comfortably.

• Food Getting Stuck in Your Mouth

People with dysphagia may notice food getting stuck in their mouth after eating, making it harder to move it to the back of the throat for swallowing.

• Having a Hard time Breathing After Meals

Individuals with dysphagia may find it difficult to breathe after meals, indicating that the swallowing process might not be as smooth as it should be, affecting the ability to breathe comfortably.

A swallowing problem may result in:

• Dehydration or poor nutrition

• Food or liquid going into the airway, called aspiration

• Pneumonia or other lung infections

• Reflux

The causes of swallowing disorders (dysphagia) are diverse and can include neurological conditions such as stroke, Parkinson's disease, or multiple sclerosis, muscular disorders like muscular dystrophy, structural abnormalities in the esophagus, and even age-related changes in the muscles and tissues involved in swallowing. Additionally, head and neck cancers, gastroesophageal reflux disease (GERD), and certain medications can contribute to or exacerbate dysphagia.

A comprehensive and thorough swallowing assessment is crucial for addressing swallowing difficulties effectively and in developing a tailored treatment plan. At Garden State Speech Therapy, we take a personalized approach to dysphagia assessment designed to capture the unique profile of each individual. The journey begins with a detailed initial consultation where our experienced speech-language pathologists (SLPs) gather information about the you or your loved one’s medical history, swallowing challenges, and personal goals.

During the assessment, a speech-language pathologist will observe how you swallow, checking for any signs of difficulty. We may also refer you for special tests, like a video or a tiny camera to see your swallowing process more clearly. These assessments help us understand your unique needs, and from there, we create a plan together to improve your swallowing and make eating and drinking a more enjoyable experience for you.

Treatment for dysphagia varies based on the unique needs of each individual patient. Treatment approaches for dysphagia may include treatment to help you use your muscles to chew and swallow, instruction on ways to sit or suggestions to help positioning while eating, strategies to help swallow better and more safely, or eating softer foods or drinking thicker drinks to help make swallowing easier.

Diagnosis and management of dysphagia involve a multidisciplinary approach, often including speech-language pathologists, gastroenterologists, otolaryngologists (ENT specialists), and radiologists. Treatment options may range from therapeutic exercises and dietary modifications to more advanced interventions, such as swallowing studies and surgical procedures, depending on the underlying cause and severity of the disorder.

At Garden State Speech Therapy, our approach to swallowing/dysphagia treatment is rooted in a person-centered philosophy, recognizing the unique and individualized nature of each person's journey. We understand that dysphagia not only affects eating and swallowing skills but also plays a significant role in an individual's quality of life. Our skilled therapists prioritize tailoring interventions to align with each individual client’s goals and values. By adopting a person-centered approach, we empower individuals to actively participate in their treatment, ensuring that therapy is not only effective but also meaningful and relevant to their lives.