Dysphagia -causes , symptoms, treatment
With dysphagia, the ability to swallow is lost. Provoke the disorder can anatomical or physiological problems in the oral cavity, larynx, esophagus.
Dysphagia leads to dehydration, malnutrition, the development of aspiration pneumonia and even to death.
Let’s find out what dysphagia is, what are the reasons for its development and consider the methods of treating this disease.
What is dysphagia?
In a normal state, food or fluid moves from the oral cavity through the esophagus to the stomach. In the case of dysphagia, this process is difficult. Depending on the severity of the disease, dysphagia is manifested by the inability to take a sip of food or water (it is difficult to swallow even your saliva), accompanied by a cough, suffocation.
The cause of the development of this disease can be both organic lesions, and disorders of the nervous system
A common cause of dysphagia is various diseases of the esophagus – inflammation of the mucosa, constriction, swelling, ulcer.
But dysphagia can develop as a result of diseases of organs located in close proximity to the esophagus. It can be a struma, a hernia of an esophageal department of a diaphragm, a tumor of a mediastinum.
Symptoms of dysphagia include:
- inability to take even a small sip;
- pain when trying to swallow food;
- increased salivation;
- heartburn, the presence of stomach acid in the throat;
- a cough when swallowing;
- the sensation of a “lump in the throat”, a stuck piece of food in the esophagus.
Often dysphagia occurs after a stroke. In most patients, the ability to swallow normally recovers spontaneously within a month. If this did not happen, due to limited intake of food and water, a person pursues weakness, dehydration, and behavioral disorders appear.
Symptoms of dysphagia may require consultation:
- otolaryngologist – if swallowing is difficult due to a sore throat;
- gastroenterologist – in case of problems with the digestive system;
- neurologist – in case of impaired brain function;
- specialist in neurorehabilitation (with the pathology of speech).
Dysphagia occurs when the work of nervous centers that control swallowing is disturbed. In this case, the food can go not to the esophagus, but to get into the trachea, causing a violent cough, accompanied by respiratory tract spasms.
In some disorders of the nervous system, dysphagia may not appear regularly. The swallowing is not broken, but the process is difficult and accompanied by painful sensations.
Causes of dysphagia
In the risk group – the elderly. Among those who are older than 65, with manifestations of dysphagia of varying severity, one in every three.
Muscular tissue is lost with age, and the connective tissue becomes less elastic. Saliva production decreases, the perception of taste and smell of food deteriorates.
In addition to stroke, dysphagia is promoted by:
- myasthenia gravis;
- Parkinson’s disease, Huntington;
- cerebral paralysis;
- motor neuron diseases;
- multiple sclerosis.
Among the causes of dysphagia, not related to the aging process and neurogenerative diseases may be:
- narrowing, swelling of the esophagus;
- acid reflux;
- cysts in the throat, larynx;
- dry mouth;
- food allergy;
- diverticula of the esophagus.
The cause of dysphagia may be radiation and chemotherapy.
Diagnosis of dysphagia
For diagnosis, a gastroenterological examination is necessary, with careful examination of the internal surfaces of the esophagus. For this use an endoscope and carefully study the mucosa of the esophagus. This allows you to identify the presence of a tumor or an ulcer. After finding the cause, a histological examination is carried out to identify the pathogen.
If in the course of the survey, the cause can not be found, a check is conducted to identify neurological disorders leading to dysphagia.
Treatment of dysphagia
- Medicinal products. If dysphagia is caused by reflux, oral medications (corticosteroids) are prescribed to relax the esophagus and minimize discomfort caused by spasms;
- Surgical intervention. It is performed in the presence of a tumor in the esophagus, diverticula, achalasia;
- Power supply through the probe. If the function of swallowing cannot be established, the supply of nutrition can be carried out using a nasogastric tube;
- Dilation of the esophagus. The operation is performed using an endoscope (under general anesthesia in combination with local anesthesia). Used either a special air balloon or a flexible plastic tube, allowing to expand the esophagus.
Natural methods of treatment of dysphagia
Changes in the position of the body and head, which helps to reduce aspiration of the contents of the stomach into the respiratory system. Changing the pose, you can change the speed and direction of movement of food or liquid, protecting the respiratory tract. Adjustment includes the inclination and rotation of the head, movement of the chin, jaws.
The method requires an individual approach and can only be used temporarily – before applying other methods of restoring the ability to swallow.
Viscous (thickened) liquids
Long-term (stationary) treatment often uses specially condensed liquids when feeding patients with dysphagia. This helps to control the progress of food, increases its nutritional value.
As a natural thickener, you can use honey (in the absence of allergies). The higher the viscosity, the slower the composition moves, which makes it easier to swallow and reduces the risk of aspiration.
Exercises for the tongue, lips, and jaws
Their purpose is to expand the range of motion, which will help not only to improve the swallowing function but also to normalize speech.
In the process, lips, jaws, tongue, soft palate, respiratory muscles, larynx are involved. For example, when performing resistance exercises, a spoon or depressor of the tongue can be used.
Changing the diet
Revising the diet is a key part of managing dysphagia. Changing the structure of food can make it safer to swallow. This applies both to the application of thickeners for liquids and to the grinding of solid products.
Portions are small, the usual diet is divided into 6-8 parts. It is necessary to try to diversify the food, enrich the taste of food since there is often no appetite in patients with dysphagia. At the same time, it is necessary to avoid both hot and strongly cooled dishes.
Can be used as an additional component of rehabilitation after a stroke, although the effectiveness of acupuncture is controversial and not clinically proven.
Dysphagia refers to those states with which one has to learn to live. Regular follow-up of the expert’s recommendations, diet, special exercises will help to adjust the swallowing process.
If it is difficult not only to swallow but also to break breathing – this is an occasion to seek immediate medical attention. This condition is fraught with not only a lack of nutrients and water, but also asphyxiation, which poses a serious threat to life.