Medanta has settled up a multispecialty dysphagia clinic and research lab(for patient requirement)
Medanta is a renowned hospital group known for its expertise in various medical specialties,..
Medanta has settled up a multispecialty dysphagia clinic and research lab(for patient requirement)
Medanta is a renowned hospital group known for its expertise in various medical specialties, including dysphagia treatment. The following are some reasons why you may consider choosing Medanta for dysphagia management:
• Multi-disciplinary approach: Medanta adopts a multi-disciplinary approach to dysphagia management. A team of specialists, including dysphagia specialist, neurologist, neuro surgeon, head & neck surgeon, respiratory doctor, critical care team, radiologist, gastroenterologists, otolaryngologists, and Chest physiotherapist, dietician, nurse, work collaboratively to provide comprehensive and personalized care.
• Experienced healthcare professionals: Medanta has a highly skilled team of healthcare professionals with extensive experience diagnosing and treating dysphagia. They stay up-to-date with the latest advancements in dysphagia management to deliver effective and evidence-based care.
• State-of-the-art facilities: Medanta has state-of-the-art facilities and advanced diagnostic tools to assess and diagnose dysphagia accurately. It enables the healthcare team to tailor treatment plans based on individual needs and provide the highest level of care.
• Customized treatment plans: Each patient's dysphagia is unique, and at Medanta, one may receive treatment plans customized to address specific needs and underlying causes. This personalized approach ensures optimal outcomes and improved quality of life for individuals with dysphagia.
• Rehabilitation and therapy services: Medanta offers evidence based comprehensive dysphagia rehabilitation services.
• Research and innovation: Medanta is committed to research and innovation to uplift the dysphagia assessment and management. It ensures access to the latest advancements and emerging treatment options for improved outcomes.
• Patient-centered care: Medanta places a strong emphasis on patient-centered care. Patients and their families receive compassionate and holistic care, addressing not only the physical issues but also the emotional and psychosocial aspects of dysphagia. We also provide home based management program for patient of dysphagia.
• Supportive environment: Medanta offers a supportive environment where patients and their families feel comfortable and well-informed throughout the treatment journey. The team provides education, counseling, and ongoing support to empower individuals with dysphagia.
Dysphagia is a medical condition where individuals experience difficulty or discomfort while swallowing. It can occur during various stages of swallowing, including chewing and forming a cohesive bolus in the oral phase, initiating the swallow and moving the bolus through the throat in the pharyngeal phase, and transporting the bolus into the stomach in the esophageal phase. Dysphagia can occur due to many factors, including neurological disorders like stroke, Parkinsons, Dementia, Head Injury, Tumors, GBS, any other neuro degenerative disorders, ENT disorders, head and neck cancers, Post Radiation & Chemotherapy, Respiratory Disorders(COPD), Gastro, Esophageal disorders, and critically ill patients. It can be seen in adults and pediatric patients. It can also seen in elderly population over 60 in one of the other form of dysphagia.
It seen in 1-17 patients.
The percentages of dysphagia survivors vary across different health conditions and populations. Among individuals with head and neck cancer (HNC) who underwent radiotherapy/chemotherapy (RT/CT), 70% are reported as survivors. Similarly, a 70% survival rate is noted in those with chronic obstructive pulmonary disease (COPD) and respiratory issues. Neurogenic disorders show an 80% survival rate, while individuals who have experienced a brain stroke exhibit a 70% survival rate. For the elderly population aged over 65 years, the survival rate drops to 13%. In contrast, the percentage of dysphagia survivors among the general population, categorized as "Normals," is 11%. These statistics highlight the diverse outcomes in dysphagia management across various medical conditions and age groups.
The prevalence of dysphagia varies across different countries and populations. A systematic review published in 2016 suggested that the prevalence of dysphagia in the general adult population ranged from 3% to 13%.
Symptoms of dysphagia can vary in severity depending on the underlying cause. The following are some common manifestations of dysphagia are:
• Difficulty swallowing
• Having to cut food into smaller pieces/ avoiding certain food because of trouble in swallowing.
• Choking or coughing
• Pain or discomfort
• Regurgitation
• Drooling
• Being hoarse
• Weight loss, dehydration and malnutrition.
• The feeling of a lump in the throat
• Unintentional weight loss
• Recurrent respiratory infections
• Having frequent heart burn
• Having food/ stomach acid back up into throat
The following are some of the common causes of dysphagia:
• Neurological disorders: Conditions that affect the nerves and muscles involved in swallowing can lead to dysphagia. Examples include stroke, Parkinson's disease, multiple sclerosis, amyotrophic lateral sclerosis (ALS), and muscular dystrophy ; MND.
• Muscular disorders: Weakness or dysfunction of the muscles involved in swallowing can result in dysphagia. It can occur in myasthenia gravis, dermatomyositis, and inclusion body myositis; GBS , MND.
• Traumatic injuries: Head, neck, or chest injuries can cause dysphagia. These injuries may result from accidents, surgeries, or radiation therapy.
• Structural abnormalities: Structural issues in the throat, esophagus, or surrounding areas can cause dysphagia. These may include tumors, blockages caused by gastroesophageal reflux disease (GERD), esophageal cancer, or benign esophageal strictures. Gastrointestinal disorders: Certain gastrointestinal conditions can contribute to dysphagia. Examples include achalasia (when the lower esophageal sphincter doesn't relax properly), esophageal spasm, and eosinophilic esophagitis (an allergic inflammatory condition).
• Medications and treatments: Certain medicines, like nonsteroidal anti-inflammatory drugs (NSAIDs), certain antibiotics, and medications that can cause dry mouth, may contribute to swallowing difficulties. Additionally, radiation therapy or chemotherapy for head and neck cancer can cause temporary or permanent dysphagia.
• Respiratory disorders like COPD, COVID-19, LRTI,URTI. Pneumonia may affect the respiratory swallow coordination due to which it may lead to aspiration.
• Neuro psychological issues: Dementia, anxiety triggering, dysphagia, pseudo dysphagia.
• Psychological factors: Emotional stress, anxiety, or depression can sometimes contribute to functional dysphagia when there is no structural or neurological cause.
• Head and Neck Cancer and Post/ chemo and radiation therapy
• ENT related issues - vocal cord palsy, laryngeal trauma, Laryngitis etc.
• Children with Cerebral Palsy, Autism, mentally challenged, and GBS.
• Aging: Normal age-related changes in the swallowing mechanism can lead to dysphagia, particularly in older adults.
Swallowing has four sequential co-ordinated phases: the oral preparatory phase, the oral propulsive phase, the pharyngeal phase and esophageal phase. Each phase as described below:
1. Oral preparatory phase: During this phase, food in the oral cavity is manipulated and masticated in preparation for swallowing. The back of the tongue controls the position of the food, preventing it from falling into pharynx.
2. Oral propulsive phase: During the oral propulsive, the tongue transfers the bolus of food to the pharynx, triggering the pharyngeal swallow.
3. Pharyngeal phase: During the pharyngeal phase, complex and co-ordinated movements of the tongue and pharyngeal structures propel the bolus from the pharynx into the esophagus. The closing of the vocal cords and the backward movement of the epiglottis prevents food/ liquid from entering the trachea.
4. Esophageal phase: During the esophageal phase of swallowing, coordinated contractions of the esophageal muscle move the bolus through the esophagus towards the stomach.
There are primarily three stages of dysphagia based on severity and location.
• Mild dysphagia: In this stage, individuals may experience occasional or intermittent swallowing difficulties. They may have trouble with certain types of foods or textures but can generally consume a wide range of foods and liquids. Mild dysphagia may result in slower eating, taking smaller bites, or needing extra time for the meal. Individuals with mild dysphagia may be able to compensate for their swallowing difficulties with minimal impact on their overall intake.
• Moderate dysphagia: Moderate dysphagia indicates more consistent and noticeable swallowing difficulties. Individuals in this stage often have trouble with a variety of foods and liquids. They may need to modify their diet by avoiding certain textures or consistencies that are particularly challenging to swallow. Chewing food thoroughly, using liquids to help swallow, or cutting food into smaller pieces may be necessary. In moderate dysphagia, mealtimes may require more time and effort, and there is a higher risk of food getting stuck or causing discomfort.
• Severe dysphagia: Severe dysphagia represents a significant impairment in swallowing function. Individuals in this stage may have extreme difficulty swallowing both solids and liquids. They may be limited to a restricted diet, such as pureed or liquid-only foods, to ensure safe swallowing. In severe cases, alternative nutrition techniques, such as tube feeding, may be necessary to meet nutritional needs. Swallowing may cause pain, discomfort, and a high risk of aspiration (food or liquid entering the airway).
What happens if you ignore the symptoms of dysphagia?
It may lead to
· Dehydration.
· Malnutrition.
· Pneumonia.
· Increased secretions.
· Repeated admissions and treatments for bronchitis, asthma, pneumonia, colds, shortness of breathing, and respiratory infections.
Whom to consult?
You can consult always a certified dysphagia specialist with RCI license.
A dysphagia specialist identifies dysphagia and plan for diagnosis of dysphagia involves a thorough evaluation that combines clinical assessments, imaging studies, and specialized tests. The following are various diagnostic test for dysphagia:
• Medical history: Your dysphagia specialist or healthcare professional will ask a detailed medical history from you. They will ask questions about your swallowing difficulties, such as when they started, their duration, and any associated symptoms. They will also inquire about your past medical conditions, previous surgeries, and current medications to identify potential underlying causes of dysphagia.
• Physical assessment: Your doctor or dysphagia specialist will conduct a thorough physical examination, focusing on your head, neck, and oral cavity. The dysphagia specialist or a healthcare professional will assess the strength and coordination of the muscles involved in swallowing. They may examine your oral structures, feel the movement of your throat, and check for any signs of abnormalities or inflammation.
Swallowing assessment
- Clinical bed side swallowing evaluation & DYE test
- Fiberoptic endoscopic evaluation of swallowing (FEES)
• Video Fluoroscopic Swallow Study (VFSS) / Modified barring swallow study/ time based swallow study
• Imaging studies
• Additional tests: Your doctor may recommend other tests depending on the suspected underlying cause. These may include:
- Esophageal manometry
- pH monitoring
- Blood tests
The following are the different treatment modalities for dysphagia are:
This could be vary from patient to patient. Management and treatment is differ
• Swallowing Rehabitalisation: Speech-language pathologists or dysphagia specialist can teach specific swallowing techniques and exercises to improve swallowing function. These may include postural adjustments, breath control techniques, and tongue or throat exercises to strengthen swallowing muscles and improve coordination and also provide the electrical stimulation therapy, sensoring vibrating stimulation therapy based on the patient requirement.
• Medications: Sometimes, the doctor may prescribe medicines to address underlying conditions contributing to dysphagia. For example, you may need to take medications to reduce acid reflux, treat inflammation, or manage muscle spasms to alleviate symptoms and improve swallowing.
• Esophageal dilation: Esophageal dilation is a procedure that involves stretching or widening a narrowed esophagus. The doctor can perform it using various techniques, such as balloon dilation or placement of a stent, to improve the passage of food and liquids.
• Surgical interventions: Occasionally, surgical interventions may be necessary to address structural abnormalities or blockages causing dysphagia. These may include procedures to remove tumors, repair strictures, or correct anatomical abnormalities.
• Feeding tubes: For individuals with severe dysphagia who cannot consume adequate nutrition and hydration orally, the dysphagia specialist may recommend feeding tubes. These can include nasogastric tubes (temporary) or gastrostomy tubes (long-term) to provide food directly into the stomach.
• Dietary modifications: Modifying the texture or consistency of foods and liquids is often a key component of dysphagia treatment. It may involve altering the thickness of liquid dietary items (e.g., thickened liquids to reduce the risk of aspiration) or modifying the texture of solid foods (e.g., pureeing, chopping, or moistening foods). A dysphagia specialist or dietitian can guide appropriate dietary modifications.
Tips for Care taker?
The following are some preventive measures you can take to promote healthy swallowing and reduce the risk of developing difficulties:
• Maintain 90 degree sitting position while eating
• Take small bites.
• Avoid straw Feeding.
• DON’T take Oral feeds /DON’T Feed the patient in lying position.
• Try to maintain and follow chin down position while swallowing
• DON’T talk while eating .
• DON’T Watch TV While eating .
• DON’T Ignore the cough /pain/respiratory issues while swallowing.
• DON’T try/ Tilt your head towards backside laterally while swallowing.
• Follow the Diet recommendations.
• Do swallow exercises regularly.
• Maintain good oral health
• Stay hydrated
• Eat mindfully
• Modify food consistency
• Be cautious with medications
• Practice good posture
• Manage reflux condition
• Address underlying health conditions
• Seek early intervention
Q: What is dysphagia?
A: Dysphagia is a medical condition characterized by difficulty or discomfort in swallowing. It can occur at any stage of the swallowing process, from chewing and forming a bolus to moving it through the throat and into the stomach.
Q: What causes dysphagia?
A: Dysphagia can be due to various factors, including neurological disorders (e.g., stroke, Parkinson's disease), structural abnormalities (e.g., tumors, strictures), muscle weakness, inflammation, or certain medical conditions (e.g., gastroesophageal reflux disease, cancer).
Q: What are the common symptoms of dysphagia?
A: Common symptoms of dysphagia include difficulty swallowing, choking or coughing while eating or drinking, pain or discomfort during swallowing, regurgitation, the feeling of a lump in the throat, unintentional weight loss, changes in eating habits, and recurrent respiratory infections.
Q: How is dysphagia diagnosed?
A: The diagnosis of dysphagia typically involves a comprehensive evaluation that may include clinical assessments, imaging studies (such as a videofluoroscopic swallow study or an endoscopy), and specialized tests to assess swallowing function.
Q: Can dysphagia be treated?
A: Dysphagia is treatable in most of the cases. The treatment approach depends on the underlying cause, severity of symptoms, and individual factors. Treatment options may include dietary modifications, swallowing techniques and exercises, medications, esophageal dilation, surgical interventions, feeding techniques/devices, and rehabilitation therapies.
Q: Can dysphagia lead to complications?
A: If left untreated, dysphagia can lead to complications such as malnutrition, dehydration, aspiration pneumonia (lung infection due to inhalation of food or liquid into the lungs), weight loss, and reduced quality of life. Seeking timely diagnosis and appropriate treatment is essential to manage dysphagia effectively.
Q: Can dysphagia be prevented?
A: While one cannot prevent all cases of dysphagia, some measures can help reduce the risk. These include practicing good oral hygiene, avoiding excessive alcohol consumption, maintaining a healthy weight, treating underlying medical conditions, and being cautious while eating and drinking (e.g., taking small bites, eating slowly).
Q: Is dysphagia a common condition?
A: Yes, dysphagia is a relatively common medical condition, particularly among older adults and individuals with certain medical conditions. It can affect people of all ages, though prevalence increases with age.
Q: Can dysphagia be temporary?
A: Dysphagia can be temporary if caused by factors such as throat infections, swelling, or medication. However, in some cases, dysphagia may be a chronic or long-term condition that requires ongoing management.
Q: Can dysphagia be a symptom of a more serious condition?
A: Yes, dysphagia can be a symptom of underlying medical conditions, including neurological disorders, head and neck cancers, gastroesophageal reflux disease, and muscular disorders. Thus your dysphagia expert will perform a thorough evaluation to identify the underlying cause of dysphagia to guide appropriate treatment.
Q: Can dysphagia affect children?
A: Dysphagia can affect children as well. It can be present from birth or acquired due to various factors such as developmental disorders, neurological conditions, or structural abnormalities. Pediatric dysphagia requires specialized assessment and management.
Q: Can dysphagia impact the quality of life?
A: Dysphagia can significantly impact an individual's quality of life. It can affect their ability to eat, drink, and enjoy meals, leading to social and emotional challenges. Managing dysphagia can improve quality of life and overall well-being.
Q: Can dysphagia be managed through lifestyle changes alone?
A: In some cases, lifestyle modifications such as altering the diet consistency, adjusting eating techniques, and practicing swallowing exercises may be sufficient to manage dysphagia. However, it is essential to consult a healthcare professional to determine the most appropriate treatment approach.
Q: Is dysphagia more common in a particular population group?
A: Dysphagia can affect individuals of any gender, race, or ethnic background. However, some population groups, such as older adults, individuals with neurological disorders, head & neck cancer patients, and those with specific medical conditions, may have a higher risk of developing dysphagia.
Q: Can dysphagia lead to social isolation?
A: Dysphagia can impact social interactions and lead to feelings of isolation or embarrassment. Difficulties with eating and drinking in social settings can affect an individual's confidence and participation in social activities. Support from healthcare professionals and a strong support network can help address these challenges.
Q: Can dysphagia affect speaking or vocal abilities?
A: Dysphagia can sometimes impact speaking or vocal abilities. The muscles involved in swallowing and speech production are closely connected. In some cases, dysphagia can affect vocal control or result in changes in voice quality. Speech therapy may be beneficial in addressing any speech-related issues associated with dysphagia.
Q: Can dysphagia lead to malnutrition?
A: Dysphagia can increase the risk of malnutrition due to difficulties in consuming adequate amounts of food and liquids. If swallowing difficulty persists, individuals may not receive the necessary nutrients, leading to malnutrition. Proper management and nutritional support are essential to prevent malnutrition in individuals with dysphagia.
Q: Can dysphagia be a symptom of a stroke?
A: Yes, dysphagia is a common symptom of stroke. The interruption of blood flow to the brain during a stroke can affect the muscles and nerves involved in swallowing, leading to difficulties in swallowing. Prompt medical attention and rehabilitation are crucial for individuals with dysphagia caused by a stroke.
Q: Can dysphagia be a temporary side effect of medical treatments?
A: Sometimes, few medical treatments, such as radiation therapy or surgery, can cause temporary dysphagia as a side effect. The tissues in the throat or esophagus may be affected during these treatments, leading to difficulties in swallowing. In most cases, dysphagia improves gradually after the completion of treatment.
