Dysphagia is simply defined as a swallowing disorder. It can occur in any of the three phases of swallowing:
Dysphagia is often noted in stroke survivors. Usually, dysphagia affects the oral and/or pharyngeal phase of swallowing. The patient may cough or choke while attempting to swallow saliva, liquids or food. A phenomenon called silent aspiration also may occur, whereby saliva, food and liquids enter into the lungs without any coughing or choking. In these patients, there are no outward signs or symptoms of a swallowing problem. A speech-language pathologist often evaluates a patient’s ability to swallow safely, without food or liquid going into his or her airway/lungs and potentially causing bronchitis or pneumonia.
Upon admission to the hospital, the patient may have a dysphagia screening performed by the nursing staff or a physician. This screening can determine whether the patient is able to be given medications orally. Following a failed screening, the patient is not permitted to consume anything by mouth to prevent the occurrence of aspiration. Whether a patient passes or fails the screening, a follow-up evaluation by a licensed speech-language pathologist will occur to accurately assess a patient’s swallowing mechanism.
The physician typically orders a bedside swallow evaluation as necessary. Once the speech pathologist completes the evaluation, he or she will make any necessary recommendations. These may include a modified barium swallow (a moving x-ray of the swallow), diet recommendations or modifications, or an alternate means of nutrition.
Remember, it is very important to follow your doctor’s guidelines on swallowing. These guidelines can help to prevent conditions including pneumonia.
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