Dysphagia

What is Dysphagia?

Dysphagia (dis-fay-juh) is a swallowing disorder that affects the mouth, throat, and esophagus, causing difficulty or even pain while swallowing. This condition is very common and can result from:

Stroke
Brain injury
Spinal cord injury
Neurological diseases, including Parkinson’s disease, amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), muscular dystrophy, myasthenia gravis, and dementia
Developmental disabilities
Cancer and cancer treatments
Trauma
Intubation and/or tracheostomy (also called a tracheotomy)
Vocal fold paralysis
Deconditioning (muscular change following a period of inactivity)

Other causes include laryngopharyngeal reflux (LPR) and gastroesophageal reflux (GERD), dry mouth, oral and dental health, and side-effects of medication.

Muscle tension dysphagia is excess tension in the muscles of the larynx, neck, jaw, tongue or chest that impacts an individual’s ability to swallow. Muscle tension dysphagia is diagnosed only when other causes for dysphagia have been ruled out.

UR Medicine's Treatments for Dysphagia

Diagnosing Dysphagia

Your care team, which will include a Speech-Language Pathologist, will conduct a swallowing evaluation, which will include:

Going over your family and medical history
An oral motor exam, assessing the cranial nerve function that impacts swallowing
Trials of different consistencies of foods and liquids, reviewed and interpreted by your Speech-Language Pathologist

In many cases, an instrumental swallowing study will be recommended. Your Speech-Language Pathologist and your physician will work together to determine the appropriate type of swallow study:

Modified bariums swallow study (MBSS): A video x-ray study that looks at your ability to swallow food and liquids. The study is completed by a Speech-Language Pathologist, a Radiologist, and a Radiology Technologist. During the study, you will eat and drink different food and liquid items containing barium, which will allow the SLP and Radiologist to see the food and liquid as you swallow under an x-ray.

Fiberoptic endoscopic evaluation of swallowing (FEES): The Speech-Language Pathologist passes a flexible endoscope through the nose into the throat to view the airway and digestive system from above. Once the scope is placed, you will eat and drink food dyed with food coloring to make it visible against the tissues of your throat.

Treating Dysphagia

Your personalized swallowing therapy treatment plan may include the following:

Education regarding the results of your swallowing evaluation.
Collaboration with another service or additional testing.
Strategies to improve your safety with swallowing.
Diet modification, which can include changing the texture of the foods you eat or thickening the fluids that you drink.
Targeted strengthening program, including exercises.
Surface Electromyography (sEMG), which provides visual feedback on the effort used during swallowing exercises.
IOPI–A targeted tongue-strengthening exercise program with visual feedback.
Neuromuscular Electrical Stimulation (NMES), which provides specific electrical impulses to help train swallowing muscles.
Respiratory Muscle Strength Training (RMST) to improve breathing, cough strength, and swallowing.
Using a flutter valve to clear the airway.
Stretches and releasing of the facial muscles to increase the range of motion of the muscles and structures involved in swallowing.

What Sets Us Apart?

At UR Medicine, we utilize a multidisciplinary approach to care for children and adults who have speech, language, cognition, and/or swallowing problems. We are exposed to more complex cases than most providers the Rochester metropolitan area and surrounding region, and each of our patients can be assured they are always in the hands of highly skilled experts.

Our speech pathologists are licensed by the New York State Department of Education and hold Certificates of Clinical Competence for the American Speech-Language-Hearing Association (ASHA), in addition to postgraduate training and certifications in several clinical subspecialties. Our Speech-Language Pathologists have specialty training and expertise in evaluating and treating swallowing disorders. They will work collaboratively with your physician and capitalize on the expertise of multiple disciplines, including GI, Thoracic Surgery, Pulmonology, Otolaryngology, and Neurology in order to best treat your swallowing problem.