DIFFICULTY SWALLOWING

Swallowing-Difficulty-(Dysphagia).jpg

SWALLOWING DIFFICULTY

 

Dysphagia is also known as difficulty swallowing and may indicate a more serious health condition that requires urgent investigation. Examples of other health conditions may include a stroke or other neurological disorders such as multiple sclerosis, gastro-oesophageal reflux disease (GORD), pharyngeal pouch, previous radiotherapy to the head and neck region, or cancer of the throat or oesophagus.

PATTERNS OF DYSPHAGIA

Dysphagia can present as either a partial or complete difficulty in swallowing, and may include;

  • Coughing when eating or drinking, with the sensation of choking or food stuck in the throat

  • Regurgitation of food through the mouth or noise leading to repetitive chest infections

  • Excessive salivation

  • Inability to chew feed properly

  • Weight loss over time

 

MANAGEMENT OF DYSPHAGIA

The management of Dysphagia is dependent on its primary cause. Hence if you are experiencing progressive dysphagia for solids and liquids you should see your GP as a matter of urgency. Your GP will decide if your symptoms and any examination findings require that you are referred urgently to a specialist head and neck surgeon.

In the head and neck clinic, you will be asked questions on the duration and pattern of your dysphagia, the presence of other symptoms such as weight loss, and whether you have risk factors for head and neck or throat cancer such as a smoking history or excessive alcohol consumption. Following this, whilst in the clinic, you will have a full Ear, Nose, Throat and neck examination, including flexible pharyngoscopy (a small camera that is passed down the nose under local anaesthetic allowing the surgeon to examine the inside of your throat). Further investigations such as a CT or MRI scan of the neck and chest, or examination of the throat and oesophagus under a general anaesthetic may be required, depending on the initial clinical assessment.  

If no surgery or other radical treatment options such as radiotherapy is required, other management strategies include;

  • Speech and Language Therapy (SALT) to facilitate a new swallowing technique.

  • Use of a pharmaceutical food thickener for liquids & soups, changing the consistency making it safer to swallow

  • Other means of delivering nutrition to the body, such as a feeding tube through the nose or directly into the stomach

  • Surgery to widen the oesophagus, by stretching it or inserting stent.

 

COMPLICATIONS ASSOCIATED WITH DYSPHAGIA

  • Dysphagia can cause coughing or choking of food and drink resulting in aspiration pneumonia which may require medical management and antibiotics.

  • It can also cause dehydration and malnutrition resulting in other complications.

  • Whilst less common in children, dysphagia may lead to behavioural problems and needs to be managed properly.