Dysphagia is a mechanism by which the human being passes food, saliva and liquids from the mouth to the stomach in an efficient and safe way.
In other words, it is the difficulty in swallowing.
This disorder can be of two types depending on its cause:
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The neurological dysphagiain which an alteration of the muscles involved in swallowing occurs.
- mechanical dysphagia. In this case, the difficulty when swallowing is caused by some type of obstruction or difficulty in transit along the bolus route.
A distinction can also be made based on where the swallowing problem is located.
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Thus, it is called oropharyngeal dysphagiawhen the problem is between the mouth and the beginning of the esophagus
- esophageal dysphagiawhen it is located between the esophagus and the beginning of the stomach.
Who does dysphagia affect?
We are not talking about a rare or minor problem, because according to the data provided by the (SEEN):
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The prevalence of dysphagia is approximately 3% of the general population.
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Those over 65 years of age are the ones with the most swallowing problems: between 10% and 30% of them.
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If we focus on the institutionalized elderly population, it affects 68%,
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And in hospitals, 34.2% of patients admitted for pneumonia suffer from this pathology.
Why is it produced?
The doctor Maria Riestraa member of the SEEN Nutrition Area, explains that there are many pathologies that can cause dysphagia, although the most frequent are neurological and oncological.
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“Half of the people who have suffered a stroke will suffer from dysphagia.
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Some neurological problems, such as dementia, Parkinson’s disease or neurodegenerative diseases can also trigger dysphagia problems.
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they usually cause it at some point
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Also esophageal tumors, not only due to the tumor itself but also due to some treatments such as radiotherapy”.
Although age is another factor that contributes to suffering from this disease. The reason is that over the years, saliva production decreases, teeth disappear and the . All of this favors older people developing swallowing problems.
How to identify dysphagia: A simple and very useful test
Sometimes swallowing problems can be confused with other problems or pathologies.
For this reason, as the doctor explains, it is important to know some of the most common signs that patients with dysphagia present:
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Difficulty passing food down the throat.
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Choking sensation or coughing when swallowing.
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Sensation that food or drink “passes through another side”.
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“If the problem is in the esophagus, regurgitation or retrosternal pain usually appears after swallowing.”
One of the most dangerous consequences of not identifying dysphagia in time is that “in the event that swallowing is not safe because the patient coughs while eating, chokes, or leaves food in the mouth for a long time, there is a significant risk of bronchial aspirationthat is, that the food or drink passes into the respiratory tract instead of the digestive tract, which can cause respiratory infections and hospital admissions ”, warns the endocrinologist.
In addition, the concern of patients and their caregivers about possible choking can lead to rejection of food, leading to weight loss, weakness, as well as malnutrition and dehydration.
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“This situation causes a worse quality of life for the patient and an increase in morbidity and mortality with the consequent increase in health spending,” says this specialist.
For this reason, nutrition specialists have validated and simple questionnaires to detect dysphagia, such as the “EAT-10”, made up of 10 easy questions that help to screen it.
After this screening, other examinations are carried out, according to medical criteria, such as radiology studies or different functional tests, which will make it easier to determine the cause and severity of the dysphagia.
If it comes out that I have problems, what should I do?
When swallowing problems are identified, it is important to follow a series of nutritional recommendations in order to keep the patient in good health.
But there are no generic recipes. Each patient will need different nutritional guidelines depending on the diagnosis and characterization of the mechanism causing the patient’s dysphagia.
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“If the person with dysphagia maintains the ability to swallow and can use the oral route, we will try to perform a adaptation of food texture. When we increase the viscosity of a food or drink, the person has more time to prepare for swallowing and thus makes it easier to control the food or drink in the mouth.
As the endocrinologist explains, depending on the degree of dysphagia, an easily chewable or completely crushed texture can be ingested.
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Some foods should be avoided so that swallowing is safe, for example, those with a mixed texture such as milk with cookies or those that give off a lot of liquid, such as some fruits.
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In the event that the dysphagia is very severethe oral route is not possible, so feeding tubes must be used to supply nutrients directly into the digestive tract, temporarily through tubes from the nose to the digestive tract or, occasionally, permanently, through a hole or hole which directly connects the feeding tube to the stomach or small intestine.
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Besides, caregivers must supervise the attitude of the person during meals. This means being very aware, for example, if he coughs after swallowing, issuing short, simple and specific commands, using a spoon or fork and avoiding feeding with a syringe.
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Finally, “the patient must also be in a proper posturedo not speak until swallowing is complete and avoid lying down until at least 30 minutes after eating, so that regurgitation does not occur ”, recommends Dr. Riestra.