The act of swallowing is very complex and highly coordinated. A normal swallow efficiently moves food from the mouth, through the throat and into the esophagus while protecting the airway.
A swallowing problem is called dysphagia. It can occur at any age and for many different reasons. Some signs of dysphagia can include difficulty chewing food and preparing it to swallow, coughing when eating or drinking, and/or food sticking in the throat. This can affect a person's health, nutrition and quality of life.
EVALUATION OF SWALLOWING DISORDERS
A clinical evaluation of swallowing begins with a thorough review of the medical history and the patient's description of the problem. Some patients are able to describe their swallowing problems in great detail while others may be unaware of the difficulties they are having.
The speech-language pathologist (SLP) evaluates the strength and coordination of swallowing muscles and will often recommend a more comprehensive evaluation of the swallow for better treatment planning.
VIDEOFLUOROSCOPIC SWALLOW STUDY
A videofluoroscopic swallow study takes place in the Radiology Department. The SLP and radiologist jointly evaluate the structures and function of swallowing. The consistency of the food/liquid swallowed and the strategies/maneuvers evaluated are determined by patient history and ability. Results of the test and recommendations are reviewed immediately after the swallow study.
FIBEROPTIC ENDOSCOPIC EVALUATION OF SWALLOWING (FEES)
The FEES allows for direct observation of swallowing by passing a small flexible scope through the nasal passage and positioning it high in the throat. A variety of food and liquid is swallowed so that the efficiency of the swallow can be evaluated. The effectiveness of swallowing strategies and/or maneuvers can also be evaluated.
TREATMENT OF SWALLOWING DISORDERS
Evaluation results, recommendations and patient goals provide the basis for comprehensive treatment planning. The plan might be preventative, rehabilitative or compensatory in nature and may include:
Swallowing therapy programs are individualized and require active patient participation. Therapeutic exercises are trained and an independent home exercise program is prescribed. Biofeedback might be used during the training process. The primary goal of therapy is to maintain good nutrition and hydration while maintaining good pulmonary health.