Eating, drinking and swallowing difficulties have potentially life-threatening consequences. They can result in choking, pneumonia, chest infections, dehydration, malnutrition and weight loss. They can also make taking medication more difficult and they can lead to a poorer quality of life for the individual and their family.
Dysphagia can affect people at any stage of their lives and speech and language therapists support and enable them to eat and drink safely.
Are you, or someone you know, suffering from difficulties swallowing?
Swallowing difficulties, also known as dysphagia, affect a significant proportion of the population for a variety of reasons. Both adults and children can be affected and at any point in their lives. There is always an underlying reason for the swallowing difficulty and can be either short or long term, static or progressive. In any event advice should always be sought.
For adults swallowing difficulties can occur post stroke, from progressive neurological disorders such as Parkinson’s disease, multiple sclerosis, motor neurone disease, Alzheimers and other dementia’s. Those with learning difficulties or post traumatic brain injuries can also be affected, along with those post head and neck surgery. Even a urinary tract infection can affect a person’s swallow.
For children swallowing difficulties can occur with cerebral palsy, cleft lip and palate, muscular dystrophy, other cranio-facial abnormalities.
Swallowing difficulties can manifest as:
- Coughing and choking during or after eating and drinking,
- Feeling like something is stuck in the throat,
- Loss of food and / or drink from the mouth,
- Holding food or drink in the mouth and not swallowing,
- Signs of anxiety or distress when eating or drinking,
- Refusal to eat or drink,
- Chronic weight loss,
- Recurrent chest infections.
Chest infections and pneumonia can be due to food or drink going into the lungs instead of the stomach. With some people this can occur without any coughing or choking and is known as ‘silent aspiration’. As such difficulty with swallowing may have life threatening consequences and can lead to an impaired quality of life.
An impaired quality of life may not just be due to health and the physical aspect of swallowing but also due to embarrassment and lack of enjoyment of food, which can have profound social consequences for both the person and members of the family. Anxiety, distress and frustration can occur.
Treatment of swallowing difficulties is through a team approach. If you, or somebody you know is suffering inform the GP. They can then signpost you to professionals who can help:
Speech & Language Therapists (SLTs) : SLTs are fully qualified to assess, advise and treat swallowing difficulties. They are the first port of call when difficulties occur. They look at the swallow to determine what is working well and where difficulties might be occurring. As well as this they also look at how posture, environment, medication and anything else might be affecting the swallow. Different textures of food and drink may be trialled to determine what is the safest and most comfortable for someone to swallow. In addition strategies or exercises might be given to improve the swallow itself.
Occupational Therapists: They can look at the utensils that are being used and give advice on anything that could be used to assist e.g. special cups, adapted cutlery. They can also give advice regarding wheelchairs and positioning. All working towards a person being as independent as possible.
Chiropractors: Can listen to the chest post swallowing. They can advise on posture, address mechanical issues that may affect the swallow or help improve posture and can advise on breathing and exercises to keep the chest clear.
Physiotherapists: Physios can listen to the chest post swallowing. They can advise on breathing and other exercises to help keep the chest clear.
Dietitian: They will work very closely with speech and language therapists to look at the nutrition and hydration the person is receiving. If the person is unable to take much by mouth the dietitian can advise on supplements and how to fortify food in order to make sure the person is receiving adequate nutrition.
Throughout any intervention the person themselves, family and carers are central. They are the ones who experience what is going on day to day, give information to the therapist and implement strategies and advice. It is a truly collaborative approach.
So if you, or a loved one, are experiencing any difficulties with swallowing no matter how big or small please do seek advice – you can be helped! Reduce the stress, anxiety and discomfort, It’s time to enjoy meals again….
Frances Webster is an Independent Speech & language Therapist that specialises in working with adults, find out more about her and her services at Acorn Health here.