Swallowing Tests After Stroke

You Might Need a Swallowing Test After a Stroke

Elderly woman with throat problems
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Swallowing tests after a stroke might be needed if your food keeps going "down the wrong pipe" when you swallow. If this happens, it might be a sign that you are suffering from swallowing dysfunction, often called dysphagia.

Along with strokes, cancer, and other illnesses can lead to difficulty swallowing. At first, difficulty swallowing can be subtle and not necessarily reveal itself as a true problem.

The evaluation of swallowing typically begins by seeking consultation with a speech and language pathologist. He or she will ask you about the specific problems you are having when you swallow.

Symptoms of a Swallowing Problem After Stroke

Commonly reported problems include:

  • Choking after drinking thin liquids, such as water or orange juice
  • Difficulty swallowing foods that are difficult to chew
  • A sensation that food is stuck in your throat or in the middle of your chest
  • A need to cough every time you swallow solid or liquid foods
  • Changes in your voice after eating (prolonged periods of hoarseness)
  • Frequent respiratory infections
  • Frequent pooling of saliva in the mouth
  • Frequent episodes of indigestion
  • Progressive, unintended weight loss
  • Taking a long time to finish each meal

Testing for Swallowing Problem After Stroke

In some cases when difficulty swallowing occurs, a speech and language therapist might be able to design a plan of therapy without the need of further tests.

But when one or more swallowing problems are found, often the speech and language pathologist will order further tests to pinpoint specifically the type dysfunction which is causing the problem.

The first step often includes is a bedside assessment which follow these steps, according to the American Stroke Association:

  • While you are in the hospital, a nurse may test your ability to swallow. If you "fail" the swallow test, the nurse may not be able to allow you to eat until a formal swallow study is done by the speech-language pathologist.
  • The speech-language pathologist will evaluate how well the muscles in the mouth move.
  • The speech-language pathologist will ask questions to see if you can remember any techniques you might need to learn.
  • The speech-language pathologist will listen to your voice for an idea of how the voicebox is working.
  • You may then be given food and liquid to swallow.

If it is not safe for a patient to swallow anything by mouth, he or she may need a feeding tube. During a patient's recovery, the speech-language pathologist will continue to evaluate his or her progress to determine when it’s safe to eat more normal foods.

Additional testing may also be needed. The following tests may be used to further evaluate the swallowing mechanism:

References
American Stroke Association.  Excerpted and adapted from "Swallowing Disorders After a Stroke," Stroke Connection Magazine July/August 2003 (Last science update March 2013

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