Dysphagia

Dysphagia is the medical term to describe difficulty swallowing. Clinically dysphagia can be classified into two categories, oropharyngeal and oesophageal dysphagia.

• Oropharyngeal dysphagia – Is the inability to initiate the act of swallowing and is a transfer problem due to the impaired ability to transfer food from the mouth to the upper oesophagus. • Oesophageal dysphagia - is a ‘transport problem’ and is defined as the sensation of difficult passage of solids from the mouth to the stomach.

Although dysphagia can happen to anyone, it is most common in older-adults, babies, and people who have problems of the brain or nervous system. This problem can extend to taking medication, which can be very problematic when a child or elderly person is ill.

Causes

If a patient has a hard time swallowing once or twice, they are unlikely to have a medical problem. However, if a patient has trouble swallowing on a regular basis they have a more serious problem that requires treatment. Various rare conditions that cause inflammation or reduced function of the oesophagus; can cause dysphagia including infections of the oesophagus or throat, cancer of the stomach or throat and swallowing large objects that get stuck (more common in children).

Symptoms

Symptoms of dysphagia can be mild or severe and can get worse over time. These include: • Have problems getting food and liquids to go down on the first try. • Gagging, choking, or coughing when swallowing. • Having food or liquids come back up through your throat, mouth, or nose after swallowing. • Feeling like foods or liquids are stuck in some part of your throat or chest. • Experiencing pain when swallowing. • Having pain or pressure in the chest or having heartburn. • Losing weight because there is not enough intake of food or liquid.

Treatment

There are a number of treatments available to patients suffering with dysphagia. if dysphagia is causing dietary problems, food supplements can be taken. These products normally contain a high number of calories, protein, or vitamins; in some cases, all three to aid the nutrition in the person with dysphagia, and to ensure they are reaching their nutritional targets. A way to manage swallowing difficulties is to thicken food and fluids to a consistency considered safe and appropriate by healthcare professionals. Thickened food and fluids are easier to control in the mouth and can be more safely swallowed by the patient.

Medications

With regard to difficulties swallowing medication, many issues can be put down to the medicine itself. Tablets and lozenges are sometimes rough and can come in large shapes and capsules. This can be a problem, particularly if the medication has to be taken on a regular basis or if numerous medicines have to be taken at the same time.

Opening up capsules or crushing tablets in order to take them should be avoided. It can lead to a change in stability and efficacy of medication and could lead to severe side-effects and can be dangerous. Chewing tablets can often leave a horrible taste in the mouth, which is why not everyone can just easily swallow their medicines with a glass of water. Oral solutions are available in the form of specially made medications but these are often costly to a patient and hard to access. OTC products such as medication lubricants which make the intake of oral tablets and medication easier are available to patients suffering from Dysphagia. A universal aid which can be clear and flavoured medication lubricants work by moistening the mucous membranes in the mouth and throat cavity and allowing the tablets to pass smoothly via the oesophagus to the stomach and can be used to take multiple tablets at the same time. Often made from food based ingredients these lubricants have no known interactions with other medications and almost immediately break down when they reach the acidic environment of the stomach, meaning they have minimal impact on the absorption of medication. These lubricants can be used by anyone who can swallow autonomously over the age of 2.

WWho? Elderly people have the highest tendency to be affected by

dysphagia, however young children can be affected by this also, and anyone who has suffered a medical condition such as a stroke or another neurological condition may be affected

WWhat are the symptoms? Patients will complain of being unable to, or to

have difficulty swallowing?

HHow long has the patient had the symptoms? If this is a recent

condition it may be that the patient is simply suffering with a sore throat or similar ailment. The length occurring, and the condition’s frequency should be noted

AAction already taken? It is important to note that the patient should not

tamper with their current medication, and advice should be given as to the reasons for this