Dysphagia: Causes and Implications

Posted on10 Mar 2021
Dysphagia is a condition where patients experience difficulties swallowing foods and fluids. Persistent dysphagia may have serious implications such as aspiration pneumonia resulting in death, if not properly treated.

What causes Dysphagia?
Dysphagia may be caused by a number of medical conditions such as stroke, cancer, Parkinson’s Disease. In some cases, the cause of dysphagia cannot be identified. Dysphagia causes may be broken down into two main categories - Oropharyngeal and Esophageal dysphagia.

Oropharyngeal Dysphagia
Oropharyngeal dysphagia refers to the weakening of lip, tongue, jaw and throat muscles due to various reasons, making it difficult to swallow food. Common causes include:

Neurological disorders such as sclerosis, muscular dystrophy and Parkinson's disease may lead to dysphagia.

Neurological damage or sudden neurological damage from conditions such as stroke, brain or spinal cord injury may temporarily or permanently affect the throat muscles and the ability to swallow.

Cancer and cancer treatments such as radiation may affect the throat muscles or scar tissues beyond repair, thus affecting the ability to swallow foods normally.

Esophageal Dysphagia
Esophageal dysphagia refers to the sensation of food sticking to the base of your throat after swallowing. Causes include:

Diffuse esophageal spasm, or poorly coordinated contractions of the esophagus while swallowing food. This condition affects the involuntary muscles in the walls of the lower esophagus, thus causing dysphagia, or regurgitation.

Esophageal stricture, or having a narrowed esophagus which traps large pieces of food during meals. This condition is usually caused by tumours. Swallowing tends to get progressively difficult when tumours are present.

Gastroesophageal Reflux Disease (GERD) may cause damage to esophageal tissues due to stomach acid spilling into the esophagus. This condition can lead to spasm and scarring, which in turns narrows the lower esophagus and traps food.

Implications of Dysphagia
Other than loss of appetite, swallowing difficulties can lead to severe conditions such as malnutrition, aspiration pneumonia and choking.

Malnutrition, weight loss and dehydration are main implications of dysphagia patients as it is harder for patients to take in adequate amounts of nourishment and fluids. It is therefore important for caregivers to follow the dietary advice of certified dieticians in order to provide the right amounts of nutrients for the patient.

Aspiration pneumonia is also one of the top concerns of dysphagia. Food, regardless of its freshness or preparation, can introduce bacteria to the lungs when they travel down the oesophagus. As such, it is recommended for caregivers to ensure that dysphagia patients maintain proper posture during meal times, and adhere to the dysphagia diet recommended.

Choking happens when food gets stuck in the throat during meal times. Food particles blocking the airway pose a threat for the safety of the patient, especially if the patient is unable to express himself/herself. To avoid such incidents, it is recommended to adhere to the dysphagia diet recommended.

If you suspect that your loved one has dysphagia, consult a certified speech therapist for detailed evaluation of the condition and further recommendations.

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