Swallowing Disorders What is Dysphagia? The term dysphagia means swallowing disorder. This can include difficulties with any part of the process from the time food enters the mouth until it reaches the esophagus (the tube which moves food to the stomach). What kind of difficulties are seen in dysphagia? Many different types of problems may arise. Difficulties can occur alone, or in combination, and may include: Getting food into the mouth and keeping it in the mouth. Chewing. Getting or keeping food in a bolus (cohesive ball) to control it for swallowing. Moving food to the back of the mouth for swallow. Moving food through the pharynx (throat). Clearing food from the pharynx or airway (windpipe). Protecting the airway to prevent choking. What causes dysphagia? A number of conditions may cause dysphagia. A partial listing is found below. Stroke Head trauma Neurological diseases such as ALS, MS and Parkinsonism Trauma or disease to the mouth, throat or airway/respiratory system Cancer Congenital conditions such as cerebral palsy or cleft palate What does the speech pathologist do to help? The speech pathologist working with swallowing disorders has been trained in: anatomy; muscle and nerve function of the head and neck; evaluation of the swallowing process to identify where the problem is and why it exists; and treatment of the disorder. Evaluation is completed through observation and other more formal means, such as videofluoroscopic swallowing studies, which allow viewing of the entire swallowing process on x-ray. Recommendations for treatment are based on the results of the evaluation. Work may include: oral motor exercises to improve lip and tongue movements; "thermal" or cold stimulation, to increase sensation at the back of the mouth; change in diet textures; positioning or special airway protection techniques. Sometimes the use of a tube through the nose (N-G tube) or stomach (gastrostomy tube) is necessary to give the patient adequate nutrition. These may be used in addition to oral feeding, or as the only means, on a long or short-term basis. Whatever the recommendation, it has been made to offer the safest and most effective type of feeding for that particular patient. What can I do to help? Specific suggestions may be given to you by your Speech Pathologist. In addition, there are general guidelines that are applicable with most patients. Don't feed if the patient is sleepy or not alert. Have the patient sitting upright (or as specifically recommended by the speech pathologist). Don't give too much food at once, or let patients "stuff" their mouths. If any problems are encountered during feeding, report them to nursing or the speech pathologist. Remain calm - and don't automatically give water - if the patient is coughing or choking. Don't distract the patient with T.V. or conversation, which requires them to talk or change positions while eating. Be patient and persistent.