Treatment of Dysphagia (Swallowing Problems)
What is dysphagia?
Dysphagia is a disorder in which a person is unable to swallow food or is having difficulty in moving food down to the stomach. The throat or esophageal muscles are unable to work properly, and that leads to this disease. It is usually seen in children, old aged persons, and people who are suffering from nervous system or brain problems. Dysphagia observed in children in general is known as pediatric dysphagia. A person can also have problems of dysphagia if he has suffered a stroke, a brain injury, or a spinal cord injury. If a person is regularly having discomfort in swallowing food or liquids, he might be suffering from dysphagia. Otherwise, if he suffers from swallowing problems occasionally, he might not have dysphagia. People suffering from dysphagia are usually not aware of their disease, as they take these symptoms lightly and confuse these symptoms with some mild body problems. Ignorance of dysphagia may make matters worse and may lead to repetitive attacks of pneumonia, or it may cause dehydration or malnutrition in a human body.
How dysphagia is caused?
Generally, in the process of consumption of food, the throat muscles contract or squeeze to gulp down the food consumed from a person’s mouth to his stomach. Dysphagia can be caused when the throat or esophageal muscles do not function as they should. There can be many reasons for the malfunctioning. The reasons include the following:
- Complications with the nervous system: Some of the problems of the nervous system are muscular dystrophy, post-polio syndrome, multiple sclerosis, and Parkinson’s disease.
- Brain or spinal cord injuries
- Esophageal spasm: This is a condition in which the esophagus muscles contract suddenly, which prevents the food from reaching the stomach. If a person suffers from esophageal spasm, then he might have dysphagia.
- Inflammation: If the body faces problems of inflammation that weakens the immune system of the body, this is called as polymyositis or dermatomyositis.
- Scleroderma: There is another disorder in which the throat muscles become frail and become hardened. This disorder is called scleroderma.
If the above conditions persist in a person, then he is unable to swallow food, and the food and other substances come back into the mouth from the throat, instead of going into the stomach. A person with dry mouth, i.e. a person’s salivary glands are unable to produce enough saliva as per the body’s requirement, it can pose a serious problem for the person with dysphagia. Under these circumstances or situations, the consumed food will be unable to be transported from the mouth to the throat. There can be some other problems, as well, that can cause dysphagia. It may happen that something might be an obstacle stopping the consumed food from travelling from the mouth to the esophagus. It might happen that on the walls of the esophagus, small sacs might grow that prevent food from entering into the throat or esophagus. This condition is called as diverticula. There can be growth of tumor cells on the walls of the esophagus that can block food’s entrance into the esophagus. GERD, which is acronym of gastroesophageal reflux disease, is a major problem that can lead to dysphagia. GERD is a digestive disorder in which the stomach fluids or other matter come back to the esophagus, which ultimately creates ulcer scars. These scars act as a roadblock for the food entering into the esophagus. Under esophagitis, the esophagus cells swell up. Swelling of the esophagus cells can be caused by an allergic reaction to certain things, like particular food items, air, or water. Esophagus cells can also swell up by GERD or by an infection.
Symptoms of dysphagia
- Heavy weight loss as a person with dysphagia is unable to eat anything. He can also face problems of malnourishment.
- Constant pain in the throat while swallowing food or liquid items.
- Food or liquids after consuming may come back to your mouth or to your nose from the stomach.
- Having acute chest pains.
- A person with dysphagia might even choke or cough while eating.
- A person suffering from dysphagia may experience things, such as food, getting stuck in the throat.
- A person with dysphagia might recurrently suffer from pneumonia attacks.
- A person having dysphagia problems might be unable to regulate the desired saliva levels in his mouth, which is essential for sending food from the mouth to the throat.
Diagnosis of dysphagia
If you have the following symptoms, you should consult your family doctor or any trusted doctor. He might then ask you about your swallowing problems and how long you have been suffering from such problems. According to your problems, he will advise you to visit an MDT. An MDT or multidisciplinary team is inclusive of a speech and language therapist (SLT), a dietitian, and a surgeon. Certain tests, like X-rays and barium swallow tests, provide pictures of the throat or esophagus that can help in detection of dysphagia. In a barium swallow test, before taking an X-ray, you are given a chalk-like liquid called barium that helps in obtaining better and clearer pictures of the internal parts of esophagus. A fluoroscopy is somewhat similar to a barium swallowing test, but with a fluoroscopy, we can obtain a video tape of the throat or esophagus. pH monitoring can be done, which helps in discovering how often the stomach acids come back to the throat from the mouth. pH monitoring can also help in obtaining results of the acidity levels in the stomach.
Upper gastrointestinal endoscopy or esophagoscopy, as it is called, can also be performed to find out about dysphagia. Under esophagoscopy, a small device is placed inside the throat or esophagus to check for swallowing problems. Esaphagoscopy helps in obtaining a detailed report of dysphagia problems. Laryngoscopy is a test that helps in looking at the back of the throat through a small microscopic instrument. During a manometry test, a tube is placed inside the throat, and it is attached to a computer. Monitoring inside the throat can be made possible through manometry. Your doctor might advise you to visit certain ENT specialists, like an otolaryngologist, who treats patients having problems of the ears, nose, and throat. A speech and language pathologist or therapist (SLT) is a specialist who treats people who have swallowing problems. Your doctor might even advise you to visit a neurologist, if you are facing dysphagia problems due to nervous system issues, brain conditions, or nerve conditions. If a dysphagia patient is having GERD problems, then a doctor might even suggest you visit a gastroenterologist, who specializes in solving digestion conditions.
Types of dysphagia
In general, there are two types of dysphagia. They are:
- Esophageal dysphagia or low dysphagia: This is usually caused by blockage created in the esophagus. It can be treated by certain types of surgeries.
- Oropharyngeal dysphagia or high dysphagia: It is generally caused by problems of tongue weaknesses when the mouth is not able to make enough saliva, due to a stroke or some nervous issues.
Treatments for dysphagia
Treatment for a patient with dysphagia may differ due to the causes of dysphagia in that patient.
Treatment for high dysphagia or oropharyngeal dysphagia.
- Changes can be made in a person’s diet plan.
In dysphagia, people tend to lose a lot of weight, as they are not able to obtain proper nutrition, which is required by the body through food. Therefore, a person with dysphagia should consult a dietitian, who is an expert in providing nutrition to the human body. A dietitian may recommend and frame a diet chart with thick fluids and soft food items so that a person with dysphagia may be able to maintain and improve his health, which may lead to the treatment of dysphagia.
- Therapy of swallowing.
Speech and language therapists (SLT) are specialists who treat people with swallowing difficulties. The SLTs teach a person with dysphagia different exercises that can help them in swallowing food. They also explain certain techniques on how food can be correctly placed or positioned inside the mouth for a person with dysphagia so that he is able to consume food. They also suggest exercises that can make the nerves, muscles, or brain work in a desirable way, and that can also be a remedy for treating dysphagia.
- Feeding tubes.
If a person has serious complications with dysphagia and is not at all able to consume food, a feeding tube can be attached either through the nose or directly in the stomach. This therapy can help the patient resolve certain issues, such as dehydration and malnutrition, which a patient with dysphagia may suffer from. There can be two types of feeding tubes: a nasogastric tube and a percutaneous endoscopic gastrostomy (PEG) tube. A nasogastric tube is attached through the nose to the stomach and is for temporary purposes. A percutaneous endoscopic gastrostomy tube is attached directly to the stomach and can last for a longer time than nasogastric tubes. A percutaneous endoscopic gastrostomy (PEG) can be risky for a human body, as it may cause internal bleeding, infections, or there may be misplacement of tubes, but people tend to prefer PEG tubes. PEG tubes are more convenient, and they are not visible to other people; therefore, they are more preferred by people.
Treatment for low dysphagia
- When the esophageal or throat muscles become too inflexible to facilitate food to pass from throat to stomach, botulinum toxin (Botox) can be used to cure such a condition. This therapy softens the throat or esophageal muscles so that food can pass through the throat or esophagus. However, this therapy does not last long. Its effects are visible up to six months.
- Medicines can be used to solve swallowing problems that are caused by indigestion. Your doctor might prescribe antibiotics to cure your digestion or GERD issues, which in turn also treats low dysphagia.
- Surgeries can also be undertaken to cure dysphagia. Surgeries may also be performed to cure cases of high dysphagia.
Dysphagia treatments using natural substances
Medicines made from natural herbs and substances can also help in treating dysphagia. Medicines made from natural herbs do not create side effects in the human body and can also strengthen the immune system of the body and lead to good health and a better lifestyle. One of the most widely used natural herbs for treating dysphagia is licorice. The scientific name of licorice is glycyrrhiza glabra, and it is sweet in flavor. The licorice plant is generally 2 meters tall and is hard in texture. It helps in digestion, which can help in solving the problems of low dysphagia, or it can also be used to solve the problems of GERD. The licorice plant is widely used for treating inflammation processes in body. It is a recognized anti-inflammatory agent. Licorice can be used for curing oral inflammation, so it soothes the throat or esophageal muscles and also allows food to pass from the throat to the stomach. It can provide relief from discomfort caused by sore throats. It can also help in curing acidity. It is recommended for a patient with dysphagia that he should consume 2-4 grams of licorice powder every day to cure dysphagia.
