Dysphagia

Question 1

What is dysphagia ?

Answer 1

Dysphagia is defined as a difficulty swallowing.

Question 2

What are some of the causes of dysphagia?

Answer 2

Dysphagia causes:
- Neurological [Problems with involuntary/ voluntary processes: stroke, degenerative conditions: MND, MS, Parkinson’s disease. Brain tumour]
- Developmental [Learning disability, cerebral palsy, cleft lip/palate]
- Obstruction [ Head and neck cancers, pharyngeal pouch, eosinophilic oesophagitis (WBCs affect cell structure), radiotherapy]
- Muscular [Scleroderma (immune system attacks healthy tissues), Achalasia (muscles of the lower part of the oesophagus fail to relax, preventing food from passing into the stomach.)
- AgeIng [may be a factor due to natural ageing processes, but not always the case]

Question 3

What are the obvious indicators of Dysphagia?

Answer 3

Obvious dysphagia indicators:
• difficult, painful chewing or swallowing
• regurgitation of undigested food
• difficulty controlling food or liquid in the mouth
• drooling
• hoarse voice
• coughing or choking before, during or after
swallowing
• globus sensation
• nasal regurgitation
• feeling of obstruction
• unintentional weight loss – for example, in people
with dementia
• food falling out
• lump in throat or mouth

Question 4

What are the less obvious indicators of dysphagia?

Answer 4

Less obvious indicators of dysphagia:
change in respiration pattern
• unexplained temperature spikes
• wet voice quality (residue in mouth)
• tongue fasciculation (may be indicative of motor
neurone disease)
• xerostomia
• heartburn
• change in eating habits – for example, eating slowly, eating softer foods or avoiding social occasions
• frequent throat clearing
• recurrent chest infections- food may be going in lung)
• atypical chest pain

Question 5

What are the possible effects of dysphagia??

Answer 5

Possible effects of dysphagia:
- Inability to eat or drink
- Weight loss
- Undernutrition
- Fear of eating
- Dehydration
-Reduced fluid intake
- Choking
- Aspiration [food, liquid, or other material enters a person’s airway and eventually the lungs by accident. May lead to a chest infection]

Question 6

How is dysphagia managed?

Answer 6

Managing dysphagia:
- Modified texture diets - different levels IDDSI (minimises risk of choking and holds bolus together)
- Positioning: tilting of the head may help
- Supervision: minimize choking risk
- Mouth care: bacteria in the mouth may go to the lungs
- Equipment
- Artificial nutrition and hydration for risk management

Question 7

What is xerostomia?

Answer 7

Xerostomia: not having enough saliva to keep the mouth wet