Dysphagia: What is it and how is it managed?

Dysphagia is a complex disorder that weakens muscles and nerves that are used for swallowing which leads to the narrowing of the back of the throat and esophagus. Although Dysphagia is more common in older adults it can occur in people of all ages. Dysphagia can be incredibly painful, making swallowing virtually impossible and because of this there can be a number of other health-related complications that may arise such as malnutrition, weight loss and dehydration.

Some of the more immediate risks of Dysphagia include choking on food intake as well as aspiration pneumonia; which is when food or liquid enters the airway during swallowing resulting in a bacteria collection in the lungs. Those who have Dysphagia may struggle with a variety of the following symptoms: pain while swallowing; inability to swallow; drooling; hoarseness; regurgitation; frequent heartburn; stomach acid backing up into the throat; coughing or gagging when swallowing and weight loss. In order to manage these symptoms, those with Dysphagia adhere to a very structured diet.

There are three widely recognized levels of Dysphagia diets. The severity of Dysphagia will determine which level of dietary restrictions need to be imposed. Level one requires foods to be pureed or smooth like pudding.   These include any foods that do not require chewing such as yogurt, smooth soups and pureed vegetables and meats. Level Two requires that foods are moist but they may involve some level of chewing such as soft, cooked, or mashed fruits or vegetables, cottage cheese, peanut butter and soft scrambled eggs. Level Three is not quite as restrictive in food preparation so can consume soft-solid foods that require more chewing. This includes meat, and fruit and vegetables that are easier to cut or mash. With all three levels of Dysphagia diets it is recommended to stay away from nuts, crackers, chips and other snack foods. While eating or drinking, regardless of the level of diet, sitting upright with your back straight, using support pillows to get into the best position, and keeping your chin tucked in to your chest all promote proper swallowing and avoidance of choking.

As well as diet changes, there are products readily available to those with Dysphagia that can be very useful in managing this disorder.  Since there are many nutritional deficits with this disorder adding extra fiber and protein supplements to your diet can be beneficial. Some levels of Dysphagia require the use of a thickening agents such as Thick-It, which is added to liquids to aid in the ease of swallowing. You can find these products at your local Nightingale Medical Supplies.

Further to dietary changes, there are exercises that can be done from home to help build up the muscles used for swallowing. A physician or speech and language therapist will be able to provide guidance on at-home swallowing exercises. In some severe cases of Dysphagia, surgical intervention may be required.

Although Dysphagia can not necessarily be cured, it can be managed and improved with medications and changes in diet.