Administering medication to children is always a challenge, which many can associate to dislike in flavour. But when this happens with adults and elders, it is dismissed as pure stubbornness. Little did we know, they may be suffering from a medical condition called Dysphagia.
Difficulty in swallowing pills and tablets or dysphagia is muscle and nerve problems. In most cases, it occurs in adults with GERD or gastroesophageal reflux disease, after stroke, or as a symptom several neurological disorders. It may also be due to the pain that a person may experience in swallowing, known as odynophagia.
- Dysphagia is difficulty in swallowing
- Oropharyngeal and oesophagal are the two types of dysphagia
- Untreated, Dysphagia can result in aspiration pneumonia
- Drooling, hoarseness, and unexplained weight loss are some symptoms of dysphagia
- Causes may include ageing, amyotrophic lateral sclerosis, Bell’s palsy, and after stroke
- Dysphagia can result in dehydration and malnutrition
- Water-swallow test is one of the ways to diagnose dysphagia
What is dysphagia?
Dysphagia came from the Greek words “dys” meaning “difficulty or disordered” and “phagia” meaning “to eat”. This condition is caused by a disease of nerves and muscles, including:
- Chewing to produce saliva
- Tongue to push the chewed food to the pharynx where swallowing should be a reflex action
- Larynx or voice box that prevents anything from going to the windpipe of the lungs.
There are two types of dysphagia, the low or oesophagal and the high or the oropharyngeal. The former is caused by blockage or irritation and happens in the oesophagus. The only treatment is a surgical procedure to solve the problem. The latter is neurological and occurs in the mouth or the throat. This condition is basically due to nerves and muscles problems and is known to be a lot difficult to treat.
Because the difficulty of swallowing is usually unnoticed or not given the proper attention it needs, many are undiagnosed and thus, untreated. This health problem heightens the risk of aspiration pneumonia or the inhalation of food into the lungs. The problem can further grow into dehydration as well as malnutrition.
Treating Dysphagia is not easy as other health issues need to be ruled out like carcinoma. Good thing that there are some signs or symptoms that a person may exhibit once he or she has dysphagia. Among these are choking, coughing or gagging when eating; drooling; acid reflux; heartburn; and hoarseness. The person suffering dysphagia may also feel pain whenever swallowing food or drink and a sensation that food is stuck in the behind the breastbone, chest, or throat.
Continuous neglect of dysphagia can eventually lead to unexplained weight loss, regurgitation, difficulty to control the food that is in the mouth, difficulty in gulping, recurring pneumonia, and inability to control the saliva in the mouth.
While dysphagia is known to be a muscle and nerve disorder, how these nerves and muscles became disordered is a question. Among the causes are natural while some others are due to another health condition. Among these are
- Bell’s palsy
- Cerebrovascular stroke
- Cleft lip and palate
- Dry mouth or Xerostomia
- Eosinophilic esophagitis
- GERD or gastroesophageal reflux disease
- Goldflam illness or Myasthenia gravis
- Motor neurone disease or Amyotrophic lateral sclerosis
- Multiple sclerosis
- Neurotoxins like snake venom
- Parkinson’s disease
Untreated, this condition can lead to dehydration because patients can’t drink properly, malnutrition due to inability to swallow food, and Pneumonia and other upper respiratory infections.
There are different ways on how to diagnose dysphagia. Among these are a water-swallow test, Barium swallow test, Chest X-ray, and Manometry.
The water swallow test includes drinking as fast as possible and also some soft food.
The barium-swallow test involves swallowing liquid with Barium, which will show in x-ray for the doctor to identify if it is a muscle or a nerve problem.
Chest x-ray helps in ruling out bronchial carcinoma
Manometry measures the changes in pressure of the oesophagus due to contractions of muscles. This test follows endoscopy when it is normal.
The treatment of dysphagia may vary depending on its type. A speech therapist can conduct swallowing therapy or feed on a tube called nasogastric tube or percutaneous endoscopic gastrostomy.
Low dysphagia, on the other hand, can be treated by dilation or inserting a small balloon into the oesophagus or Botox or Botulinum toxin to paralyse achalasia or stiff muscles.
There are also prescription drugs for the patient with complicating health conditions.
Modern practitioners also recommend the use of pill or tablet liquefier like myLiquitab to ensure faster administration of medication.