Dysphagia Services

Swallowing Disorders (also called DYSPHAGIA)

Problems chewing or swallowing that can lead to:

  • Dehydration
  • Malnutrition
  • Food or liquid going into the airway, called aspiration
  • Frequent pneumonia or respiratory infections
  • Less enjoyment of eating
  • Embarrassment when eating because of drooling or other problems
  • The need for tube feeing or other ways to get nutrition

Symptoms of Swallowing Disorders

  • Difficulty chewing
  • Coughing or choking
  • Needing extra time and effort to eat
  • Drooling or spilling food from mouth
  • Complaints of food sticking
  • Wet or gurgly voice after swallowing
  • Difficulty breathing while eating and drinking
  • Pneumonia
  • Significant or unexplained weight loss

The three phases of swallowing

Oral phase problems

  • Trouble chewing or moving food and liquid from your mouth to your throat
  • Having some food in your mouth after you swallow
  • Poor control of food and liquid

Pharyngeal phase problems

  • Having a hard time starting a swallow
  • Getting food or liquid into your airway, called aspiration
  • Having some food or liquid stay in your throat after you have swallowed

Esophageal phase problems

  • Food getting stuck as it moves from your throat into your esophagus
  • Poor movement of the esophagus so food doesn’t pass easily into your stomach
  • Food coming back up (reflux)
  • Pockets in the esophagus that catch food

Diagnostics

Clinical Swallow Evaluation

  • Thorough review of history
  • Assessment of oral motor structures and functions
  • Assessment of secretion management
  • Assessment of response to feeding trials of various consistencies
  • Assessment of effects of swallow strategies

Modified Barium Swallow Study (MBS)

  • Completed in collaboration with Radiology
  • Dynamic test which includes oral presentation of barium with varying volume
    and consistency
  • Allows for observation of bolus progression from oral to pharyngeal to upper
    esophageal phases of swallow
  • Provides assessment of anatomy and physiology
  • Provides assessment of airway protection with identification of penetration
    and aspiration
  • Allows visualization of efficacy of swallow strategies and assists with
    treatment planning

Fiberoptic Endoscopic Evaluation of Swallow (FEES)

  • Portable procedure that allows direct visualization of the oropharynx and
    larynx utilizing a flexible scope that is passed transnasally
  • Dynamic test which includes oral presentation of food and liquids to assess
    tolerance
  • Provides assessment of anatomy and physiology
  • Provides assessment of airway protection with identification of penetration
    and aspiration
  • Allows visualization of efficacy of swallow strategies and assists with
    treatment planning

Treatment

Rehabilitative: targets restoration of normal swallow function

  • Biofeedback including sEMG
  • Electrical stimulation
  • Exercises
  • Sensory stimulation

Compensatory: modifications to diet consistency and patient behavior

  • Diet modifications
  • Equipment
  • Maneuvers
  • Pacing and feeding strategies
  • Postural techniques

For any questions or to schedule an appointment, please call 419-468-0547

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