Dysphagia : Swallowing Problems After a Stroke

Dysphagia Basics

A man with dysphagia. Adam Gault/Getty Images

Dysphagia is an impairment in the ability to swallow due to a stroke or another injury of the nervous system. Dysphagia can be mild and relatively manageable, but it can also be rapidly progressive and even deadly. Severe dysphagia may result in aspiration pneumonia.

How Do We Swallow?

Swallowing is actually a sophisticated process that involves a well orchestrated sequence of muscle movements. These begin in the mouth with the coordinated action of muscles involved with chewing and the formation of a food bolus, a small and soft mass of food.

This is followed by the transfer of this food bolus towards the back of the throat, the pharynx, where it triggers an automatic sequence of movements of several small muscles that then work together to move the food into the esophagus, the "food pipe" which finally brings food to the stomach. All this must occur while preventing food or liquid particles from entering the lungs, which could cause aspiration pneumonia.

Swallowing And The Brain

The brain is a complex organ in which different areas are designated for the control of different functions such as swallowing. In fact, there are multiple areas of the brain that are dedicated to the control of swallowing. Damage to one or more of these areas, as can happen with stroke, can lead to dysphagia.

Dysphagia Explained

Dysphagia can result from several medical and non-medical conditions, some of which occur more than others. Stroke, for instance, is common, while Guillain Barre syndrome is much more rare.

Dysphagia can be harmless, but it can also have detrimental consequences.

How Is Dysphagia Evaluated?

Dysphagia can begin shortly after a stroke, but it can also begin weeks or months after a stroke. Finding out exactly why you're having problems swallowing is an important step in the formulation of a treatment plan.

If you have dysphagia, your doctor may recommend a speech and swallow evaluation, which examines your muscle and nerve function in order to determine exactly where your swallowing problem originates. This aids in designing a therapy plan to better manage your swallowing problems.

Dysphagia Therapy

Dysphagia therapy is key for the recovery of swallowing function, particularly after stroke. Dysphagia can be medically managed, but a feeding tube may be necessary if a choking persists and worsens. Learning about the importance of extensive and intense dysphagia therapy, and about a variety of exercises designed to help you regain the ability to swallow, can get you acquainted with what's to come. Find out more about overcoming dysphagia here.

When Is a Feeding Tube Really Necessary?

Sometimes dysphagia is so severe that it requires the temporary, or even permanent, placement of a feeding tube. Although at first the decision to agree to have a feeding tube placed by your doctor might seem straight forward, it rarely is.

In fact, deciding whether or not you should agree to the placement of a feeding tube (for you or someone else) can be an extremely difficult task. Talk with your doctor, or your loved one's physician (if you're a caretaker), about the possibility of this being a necessity.

Edited by Heidi Moawad MD

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