Dysphagia: Difficulties Swallowing
Health Guide September 26, 2006
After my stroke, I spent six months in rehabilitation. I had a speech pathologist to help me with my drawn face, memory loss and speech. I had an occupational therapist to help me with my right arm and show me how to function in life just in case it never moved again. And finally, I had a physical therapist to help me with my right leg, which was weak and caused me to limp.
Luckily, everything got moving again and I’m more than 90 percent back to normal. But, it seems I’ve been having another side effect of my stroke, five years later. Lately, I’ve been having trouble swallowing. It feels like my throat is clogged up and lets food and liquids down either very slowly or not at all. When it’s not allowed, the water or whatever I’m drinking comes back up and into my windpipe, giving me quite a coughing fit. Some days, though, I don’t notice a thing, while other days I choke on my own saliva. Yes, I know, it’s disgusting and scary.
It turns out, swallowing difficulty after stroke may occur in up to 47% of cases. It’s called dysphagia. People with this condition have difficulty swallowing and may also experience pain while swallowing. Some people may be unable to swallow at all, this includes liquids, foods, or saliva. Eating, of course, becomes a challenge. Often, dysphagia makes it difficult to take in enough calories and fluids to nourish the body. Fortunately, I’m not that bad. I have no problem getting my calorie intake, which some days, isn’t good.
I didn’t realize how complex swallowing really is. In fact, 50 pairs of muscles and many nerves work together to move food from the mouth to the stomach. Dysphagia occurs when there is a problem with any part of the swallowing process. Any condition that weakens or damages the muscles and nerves used for swallowing may cause dysphagia. For example, people with diseases of the nervous system, such as cerebral palsy or Parkinson's disease, often have problems swallowing, as well as victims of stroke or a head injury. Infections can cause the esophagus to become narrow. Also, cancer of the head, neck, or esophagus may cause swallowing problems.
The treatment for dysphagia varies. Depending on the case, surgery or medication may help. Patients may need to see a speech-language pathologist who is trained in testing and treating swallowing disorders. The speech-language pathologist will test the person's ability to eat and drink and may teach the person new ways to swallow. Treatment also could involve learning exercises to strengthen weak facial muscles or to improve coordination.
If you have a swallowing problem, you may need to consult with an otolaryngologist (physician with special training in disorders of the ear, nose, and throat) or a speech-language pathologist trained in dysphagia. I’m not for sure my stroke has caused my problems with swallowing. If so, why did it take five years to happen? These are all questions I hope to get answers to during my doctor’s appointment next month. I’ll keep you posted.
What is a stroke?
Information on dysphagia from the Digestive Disease Center
Information on dysphagia from the National Institutes of Health