Dysphagia is the medical term for the symptom of difficulty in swallowing. Although classified under "symptoms and signs" in ICD-10, the term is sometimes used as a condition in its own right. Sufferers are sometimes unaware of their dysphagia.It is derived from the Greek dys meaning bad or disordered, and phago meaning "eat".
In the past two decades, noteworthy advances have been made in measuring the physiologic outcomes of dysphagia, including measurement of duration of structure and bolus movements, stasis, and penetration– aspiration. However, there is a paucity of data on health outcomes from the patients’ perspective, such as quality of life and patient satisfaction. A patient-based, dyspha- gia-specific outcomes tool is needed to enhance infor- mation on treatment variations and treatment effective- ness. We present the conceptual foundation and item generation process for the SWAL-QOL, a quality of life and quality of care outcomes tool under development for dysphagia researchers and clinicians
The objective of this study was to conduct a cross-sectional analysis of the prevalence of identifiable, eating-related difficulties in a multicare level facility for elderly persons and to determine their distribution across various levels of care. It was anticipated that a wide- based screening initiative would aid the multidisciplinary team in planning a more global strategy for dealing with mealtime problems.
A mealtime screening tool was administered to 349 residents of a home for the aged to determine the prevalence of mealtime difficulties including, but not limited to, dysphagia. Mealtime difficulties, as assessed during a single meal observation of each resident, were documented in 87% of these individuals. Though 68% exhibited signs of dysphagia, 46% had poor oral intake, 35% had positioning problems, and 40% exhibited chal- lenging behaviors. An increased prevalence of mealtime difficulties was related to both the presence and degree of cognitive impairment. Oral intake was best among residents with severe cognitive impairment, many of whom received partial to total feeding assistance.
In many cases, dysphagia can occur after a stroke. Along with dysphagia, brain damage and the inability to eat can occur. Due to the difficulty swallowing and the necessity to eat, a person with dysphagia needs to be attended to very regularly. Feeding assistants need to be used very frequently.
The literature clearly indicates that clinical, bedside evaluation is an inadequate and poor predictor of pha- ryngeal phase dysphagia [1–3]. Although a number of studies have attempted to identify a consistent and reli- able set of clinical indicators for diagnosing pharyngeal phase dysphagia at bedside examinations [1–6], no con- sensus has been reached as to the identification or hier- archical ordering of indicators
The traditional bedside dysphagia evaluation has not been able to identify silent aspiration because the pharyngeal phase of swallowing could not be objectively assessed. To date, only videofluoroscopy has been used to detect silent aspiration. This investigation assessed the aspiration status of 400 consecutive, at risk subjects by fiberoptic endoscopic evaluation of swallowing (FEES). Our study demonstrated that 175 of 400 (44%) subjects were without aspiration, 115 of 400 (29%) exhibited aspiration with a cough reflex, and 110 of 400 (28%) aspirated silently.
Dysphagia is common in children with severe developmental disabilities. The nature of these difficul- ties can predispose them to foreign body ingestion. This article presents a case that highlights the need for vigi- lance in diagnosing dysphagia in children with multiple and complex developmental disabilities where severe cognitive impairment and an inability to communicate may mask the presence of underlying problems.
During the early days of an acute stroke, a patient's neurological condition can deteriorate and swallowing may be affected. Consequently, the ability to swallow cound change daily, which may go unnoticed by an untrained observer.
Manometry of the pharynx and the upper esophageal sphincter (UES) provides important information on the swallowing mechanism, especially about details on the pharyngeal contraction and relaxation of the UES. However, UES manometry is challenging because of the radial asymmetry of the sphincter, and upward movement of the UES during swallowing. In addition, the rapidity of contraction of the pharyngoesophageal segment requires high frequency recording for capturing these changes in pressure; this is best done with the use of solid state transducers and high-resolution manometry. UES manometry is not required for routine patient care, when esophageal manometry is being performed. The major usefulness of UES manometry in clinical practice is in the evaluation of patients with oropharyngeal dysphagia.
People with dysphagia may have difficulty talking, understanding, listening, writing or doing numeral calculations. They may be mildly or severely affected. Everyday tasks, such as shopping or answering the phone, may be impossible. People with the condition can think clearly and know what they're feeling, and their intellect is maintained. They're often mistakenly thought to be drunk or mentally confused. Avoiding the causes of brain injury that may result in dysphagia is important. For example, not smoking and keeping blood pressure at a safe level will reduce the risk of stroke.
The brain damage that results in dysphagia is often caused by a stroke, when the blood supply to the brain is interrupted. Infection and inflammation, head injury or a brain tumor may also damage the brain in this way.