5 Dysphagia Issues to Look For
Dysphagia is the fancy term for difficulty eating and swallowing. Such issues can be at the heart of many picky eating habits in toddlers and decreased enthusiasm for eating in the adult population. Difficulty may occur in any "phase" of swallowing; while food is in the mouth (oral phase), during the process of swallowing (pharyngeal phase), or when the food has traveled further down the esophagus after the swallow (esophageal phase).
#1: COUGHING OR WATERY EYES
When food goes "down the wrong pipe" a healthy, strong person is going to cough to expel the food away from the vocal folds. In medically compromised or fragile populations a strong "protective and productive" cough may not occur. In these cases medical management and a change of diet to decrease the risk of aspiration are warranted.
#2: REJECTING FOODS
Children (especially) may reject foods that are just too tough to eat. If a child cannot control food in the mouth due to weakness or incoordination they may respond by rejecting it outright. Children may choose what consistency foods they like based on this criteria. Mixed consistency foods (such as a soup or a sandwich) may provide an extra challenge. Learning how to maturely use tongue, lips, cheeks and jaw can be key to helping ease the symptoms associated with "picky eating".
#3: REGURGITATION/ FREQUENT HEARTBURN
Regurgitation and heartburn can occur when sphincters (muscular valves) malfunction. The valves that keep food moving down or staying down in the stomach may malfunction, and when this happens food and/or stomach acid can come back up. This is seen often in the immature swallowing systems of babies and also older patients after a stroke or other event. Different tests can be conducted by medical professionals to determine if this is happening.
#4 VOCAL HOARSENESS
One of the first questions that speech therapists ask when we hear a hoarse voice is: "Is this due to how the person uses their voice OR could it be due to heartburn/regurgitation?". This is because when stomach acid backs up the esophagus it can spill over into the trachea where it is stopped by the vocal folds. Upon visual inspection, a pattern of "cobblestoning" can occur on or near the vocal folds. Hoarseness is the result.
#5 LABORED BREATHING/INCREASED PULSE
If you see labored breathing during or after a swallow it is not a good sign. Some medical events may decrease sensation or use of one's vocal folds. When this happens, a person who should cough to protect their lungs, cannot do so. Foreign material can invade the lungs and set the stage to make breathing difficult. Pneumonia is just one concern in such cases.
If you have concerns about swallowing you are advised to seek medical attention from your doctor who can make the referral to a team of individuals that may include, Ear Nose Throat Doctor, Speech Therapist, Pulmonologist, Gastroenterologist, Radiologist and others.
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