UNDERSTANDING DYSPHAGIA

Dysphagia is a medical condition which describes the difficulty in swallowing solids or liquids. A person suffering from dysphagia may either have problems forming a bolus (the mass of food to be swallowed) in the mouth or have difficulty moving the bolus from the mouth to the stomach.
Swallowing is a complex process involving various muscles, glands and nerves. The swallowing process consists of three distinct phases, each controlled differently.

Dysphagia can originate from a disorder in any one or more of these swallowing phases.
Swallowing difficulty can occur at any age but is more common in older adults. Almost 14% of the population over the age 50 have clinical signs of dysphagia. As dysphagia can cause other health problems, early diagnosis and the right treatment are the best recommendations for good quality of life.

swallowing

What causes dysphagia?
Dysphagia is often caused by disease or damage to the nervous system, spasms of the muscles in the esophagus or other conditions that physically block the esophagus, or cause it to narrow.
Dysphagia can occur with illness such as stroke, head and neck cancer, a tracheostomy (surgically created hole in the windpipe), Alzheimer’s disease and Parkinson’s disease. In older people, difficulty swallowing solids or liquids may occur due to changes in neural and muscular function that develop with ageing as well as a lack of teeth, poorly fitting dentures, inadequate saliva production or sores on the tongue or gums.

What are the risks related to dysphagia?
Dysphagia often makes eating and drinking painful, stressful, and less enjoyable. Swallowing difficulty can lead to a reduction in food and drink consumption. Many individuals do not seek care or mention, all of their symptoms to a healthcare professional. Thus, few receive a proper diagnosis and the right medical treatment. If symptoms continue to persist, they can eventually lead to serious health complications such as malnutrition, dehydration, weight loss and respiratory infections (namely, pneumonia). People with dysphagia often avoid social activities. It can be a special challenge for individuals with dysphagia to have the right intake of nutrients. A care plan which adapts the way that food and drink is consumed is an important step in management of the condition.


What are evidence-based methods of dysphagia management?

Despite the significant health risks linked todysphagia, the conditionstill remains under-recognized and under-diagnosed.Evidence suggests that only 25% of individuals who have dysphagia are diagnosed with the disorder. Systematic screening of at-risk patients is justified for the early management of dysphagia.
Scientific societies recommend evidence-based methods of dysphagia management. Screening at-risk patients is suggested as the first step in dysphagia care. For example, the American College of Chest Physicians (ACCP) clinical practice guidelines recommend swallowing evaluation for:
  • ‘Patients who are at high risk for aspirationhaving conditions including:
    Cerebrovascular disease (stroke),
    Head & neck cancer,
    Head trauma,
    Parkinson’s disease,
    Alzheimer’s disease’
  • ‘Patients with cough that is related to pneumonia and bronchitis’

In a stepwise, integrated manner the ACCPguidelines recommend:
  • ‘Further evaluation, including a chest radiograph and a nutritional assessment, should be considered in patients with cough or conditions associated with aspiration’

Screening for dysphagia can effectively identify symptom severity in a quick and easy mannerso the health risks may be avoided and proper intervention may be recommended earlier.
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IDENTIFY THE SIGNS OF DYSPHAGIA : THE FIRST STEP TO HELP IMPROVE SYMPTOMS

Be aware of signs and symptoms linked to dysphagia.

MEASURE THE SEVERITY OF SYMPTOMS WITH AN ACCURATE METHOD

The EAT-10 is a quick and easy self-check, clinically proven to identify those at risk for dysphagia.

PLANNING AN APPOINTMENT: PREPARE WELL FOR BETTER PERSONAL CARE

For those with diagnosed dysphagia, options are available to help manage swallowing difficulty and improve symptoms. The EAT-10 total score and individual answers are helpful information for a personal care plan. Be well prepared, and bring the completed EAT-10 form along to the appointment.

Specialized solutions are available



A care plan that adapts the way that food and drink is consumed is an important step in the management of dysphagia. Modified foods and fluids can help to make eating easier and swallowing safer.  Enriched items may be important, because it can be a special challenge for individuals with dysphagia to have the right intake of nutrients and fluids. A variety of solutions designed for the special needs of dysphagia care are available:



  • Powder Thickener: To modify the consistency of food and drink without changing the flavor or color.
  • Ready-to-drink thickened beverages: To promote the right intake of fluid and adequate hydration.
  • Instant adapted food items: A convenient way to prepare foods suited for easier swallowing and enriched in nutrients often lacking in the diet to reduce the risk of malnutrition.
  • Oral nutritional supplements: To use in addition to a normal diet, to enhance the overall daily intake and reduce the risk of malnutrition.

Only a healthcare professional can recommend a personal care plan.  You must seek medical advice on the best strategies to manage dysphagia and improve symptoms.

What the
experts say


Prof. Clave
How to identify dysphagia in patients
Prof. Clave
The link between dysphagia and aging



DISCOVER A STORY
  • Jaume Palau Rifols
    Patient, Barcelona Spain
    Dysphagia treatment allows me to still enjoy the food and drinks I like



The Nestlé Health Science range of tailor-made nutritional solutions
Resource® ThickenUp® Clear is an innovative thickening agent designed to rapidly thicken liquids, oral nutritional supplements and food for patients with dysphagia or swallowing difficulties.