The nurse is caring for a client who has developed dysphagia and is unable to swallow

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Eating and drinking, for hydration, nutrition and pleasure, is a vital part of our life. Difficulty swallowing can limit what people can eat and drink, leading to frustration, stress and even health problems.

What is dysphagia?

Dysphagia is the medical term for difficulty in swallowing. This includes problems with sucking, swallowing, drinking, chewing, eating, dribbling saliva, closing lips, or when food or drink goes down the wrong way.

Early signs of dysphagia are coughing, gagging or choking while eating and drinking.

Dysphagia is a common problem affecting elderly people. It can lead to aspiration, which means food or drink go into the airway rather than the stomach.

Dysphagia and aspiration can lead to dehydration, malnutrition and pneumonia. For these reasons, and also because dysphagia can be caused by serious medical conditions, if you think you or someone you care for has difficulty in swallowing, talk to your or their doctor.

What causes dysphagia?

Common causes include reflux and problems with the nervous system, muscles or structures of the head and neck.

Reflux

Reflux occurs when stomach acid leaks from the stomach and moves up into the oesophagus. Read more about reflux here.

Nervous system problems

Conditions that damage the brain and nerves can cause dysphagia, including:

• stroke – almost half of all people who have had a stroke will have difficulty with swallowing
• head injury
• Parkinson’s disease
• motor neurone disease (MND)
• dementia
• cerebral palsy
• achalasia (a condition affecting the oesophagus (the food pipe) that prevents food from entering the stomach properly)

Muscle problems

Muscle problems of the face or neck, or spasms of the oesophagus, can cause problems with swallowing.

Structural problems

Swallowing problems can also develop due to damage to structures such as the lip or palate. Sometimes growths like some cancers of airway or oesophagus can cause swallowing difficulties.

Signs and symptoms of dysphagia

Signs and symptoms of dysphagia include:

• food or drink gets stuck in the throat or goes down the wrong way
• eating a meal takes a long time (more than 30 minutes)
• the need to cough or clear the throat during or after eating and drinking
• regular heartburn
• short of breath when eating and drinking
• avoiding some foods because they are hard to swallow
• regular chest infections for no obvious reason

Babies that have difficulty sucking during breast or bottle feeding could have dysphagia.

How is dysphagia diagnosed?

Your doctor will ask about symptoms, examine you and might also refer you for tests such as:

• a barium swallow – swallowing a non-toxic substance called barium shows your upper digestive system on an x-ray
• endoscopy – to view inside the oesophagus
• muscle testing – to see if your oesophagus is working properly
• CT scan
• MRI scan

How is dysphagia treated?

If you have dysphagia, the most appropriate treatment will depend on the cause. Treatment can include:

• changing the textures of foods or drinks
• learning new swallowing techniques
• doing exercises to help muscles work better and stimulate nerves that trigger the swallowing reflex
• taking medication to reduce stomach acid reflux or relax your oesophagus

In severe cases, you might need to change to a liquid diet, or have food and drink through a feeding tube that goes directly into your stomach.

A range of health professionals can help with dysphagia, including doctors, speech pathologists, occupational therapists, physiotherapists, dietitians and lactation consultants. 

More information

For more information on dysphagia, see your doctor or a speech pathologist.

You can also contact the Stroke Foundation or mndcare.   

To check your symptoms, use healthdirect's online Symptom Checker.

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