Dysphagia
Oral Preparatory and Oral Phase refers to before the swallow. This is the beginning phase when the food or liquid is chewed or manipulated in the mouth to form a cohesive bolus and begins the propulsion of food towards the back of the mouth. This includes sucking, chewing, sealing lips, moving food back toward throat, holding food in cheeks, etc.
Dysphagia is difficulty with the swallow function that may involve the mouth, throat, and/or esophagus.
Swallowing dysfunction may occur in the oral preparatory/oral phase, pharyngeal phase, or esophageal phase. It can also include a combination of these phases and may result in aspiration.
Pharyngeal Phase refers to when the food is in the process of being swallowed. The bolus is moved through the pharynx (throat) by muscle contractions while the body closes off the airway. This phase includes function of muscles that trigger the upper esophageal sphincter to open, ability to protect the airway, ability to sense food in the wrong part of the throat and clear it by coughing or clearing throat, and the ability for our muscles to squeeze the food down into the esophagus.
Esophageal Phase refers to when the food has been swallowed and enters the esophagus on its way to our stomach/digestive system. This would include reflux and sensation of food sticking (globus).
Malnutrition and dehydration, aspiration pneumonia, compromised general health, chronic lung disease, choking, and even death may be a consequence of dysphagia.
Adult Dysphagia
Adults with dysphagia may experience a decreased quality of life. This may be due to some adults with dysphagia having decreased interest or less enjoyment of eating or drinking. Adults with dysphagia may also feel embarrassed leading to isolation in social settings that involve eating. Adults with dysphagia may also have to make significant lifestyle changes that not only affect them, but their families and loved ones as well.
Individuals with Parkinson's Disease, amyotrophic lateral sclerosis (ALS, or Lou Gehrig's disease), stroke, multiple sclerosis, Dementia, traumatic brain injury, and head and neck cancer are all at a higher risk for dysphagia.
Signs of dysphagia may include:
Dysphagia is more common in older adults ranging from 22% to 30% in individuals over 50 years old. This increases significantly to 68% in long term care residents. A report by the Agency for Health Care Policy and Research estimates that approximately one third of patients with dysphagia develop pneumonia and that 60,000 individuals die each year from such complication.
extra effort or time needed to chew or swallow
wet or gurgly sounding voice during or after eating or drinking
weight loss, malnutrition, and dehydration from not being able to eat enough
recurring aspiration pneumonia respiratory infection and/or fever
inability close or seal lips leading to foods or liquids leaking from the mouth
complaints of pain when swallowing
drooling and poor oral management
complaints of food "sticking"
globus sensation or complaints of a "fullness" in the neck
food and or liquids leaking from the nose
food or liquid remaining in the oral cavity after the swallow
changes in eating habits like avoiding certain foods/drinks
coughing during or right after eating or drinking
difficulty coordinating breathing and swallowing