Swallowing is a natural reflex occurring 203-1008 times a day1, right? But imagine if this process became a constant challenge!
In recent years educational awareness and community involvement have increased surrounding the issue of food allergies with a huge focus on peanut allergies. For dysphagia, however, there has been little awareness surrounding this debilitating condition or support for patients who suffer with it.
“Part of the reason there hasn’t been enough awareness is because it is a silent problem where people who suffer either die from the complications or suffer in silence.” said Dr. Peter Belafsky, MD, PhD, Professor, Director of the Voice and Swallowing Center, University of California, Davis. “They can have a feeding tube under their shirt and nobody knows about it while they become socially withdrawn because they can’t socialize in the same way.”
Each year about 300,000 to 600,000 Americans experience dysphagia as a result of neurological disorders such as stroke. Of the stroke patients who experience dysphagia, 43 to 54% experience aspiration, and of those patients 37% develop pneumonia. Of the patients who develop pneumonia, 3.8% will die from pneumonia if they are not part of a dysphagia diagnosis and treatment program.2
“Also, on the clinical side, there is a lot of frustration because previously there was not a lot that could be done to help these people. Now that we are introducing more treatments, a lot more people are interested because there are things that we can do to help as physicians,” said Dr. Belafsky.
Mild dysphagia can manifest as throat clearing while eating or drinking. More severe complications include choking, chronic pneumonia, or feeding tube dependence. Other symptoms can include painful swallowing, hoarseness, regurgitation, and weight loss. Up to 48% of stroke patients who have dysphagia will experience malnutrition.2
“Swallowing, and more importantly, the activities that are dependent on it (sharing a meal, communicating easily, uninterrupted sleep) are fundamental to our quality of life as human beings,” said Dr. Maggie Kuhn, MD, Assistant Professor of Otolaryngology, University of California, Davis. “Frequently, we don’t appreciate this until we encounter a swallowing problem, and sometimes, it’s too late for meaningful intervention.”
Depending on its severity, dysphagia can occur as a mild annoyance or a profound, life-altering condition.
“You can’t go out to meals, and so much of your social life revolves around food and drink,” said Dr. Peter Belafsky. “Imagine going out to dinner and the person across from you doesn’t order anything. It’s very disconcerting and people do avoid those situations. So those with dysphagia, and also their caregivers who can no longer go out with them, quickly become socially isolated.”
“Treatments vary from simple counseling and preventive strategies, swallowing therapy and compensatory maneuvers, minimally invasive procedures including balloon dilation if appropriate, to more invasive interventions such as tracheostomy or total laryngectomy in the most severe cases,” said Dr. Kuhn.
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1Lear CS, Flanagan JB, Moorrees CF. The frequency of deglutition in man. Arch Oral Biol. 1965:10(1);88-100.
2Diagnosis and treatment of swallowing disorders (dysphagia) in acute-care stroke patients. Agency for Healthcare Research and Quality Web site. http://archive.ahrq.gov/clinic/epcsums/dysphsum.htm. Accessed June 2, 2016.
Dr. Peter Belafsky is a paid consultant for Cook Medical.
Dr. Maggie Kuhn is not a paid consultant for Cook Medical.