Dysphagia

Around 590 million people worldwide live with dysphagia

Dysphagia is defined as the inability or difficulty in swallowing food effectively (in a single swallow) and safely (without choking).

Oropharyngeal dysphagia (OD)

Oropharyngeal dysphagia (OD) originates in the pharyngeal area and makes it difficult for solid foods and liquids to pass from the very beginning of the swallowing process. In severe cases, constant aspiration may occur, causing food to pass into the trachea and potentially leading to choking.

This type of dysphagia is very common in older adults and in patients with neurological diseases affecting the central and peripheral nervous systems (Alzheimer’s disease, Parkinson’s disease, ALS, stroke, dementia), as well as due to structural causes (cardiothoracic and abdominal surgery, head and neck cancer, prolonged intubation, tracheostomy, lung transplantation) and muscular disorders.

Oropharyngeal dysphagia
Oesophageal dysphagia (ED)

Oesophageal dysphagia (ED)

In the case of oesophageal dysphagia (ED), swallowing difficulties occur as food travels down the oesophagus. This type of dysphagia is usually caused by different conditions that directly affect or are related to the oesophagus (hiatal hernia, achalasia, oesophageal spasms, gastro-oesophageal reflux, oesophageal stenosis, cancer and tumours in the stomach and oesophageal area).

The clinical consequences that dysphagia may cause include aspiration pneumonia, dehydration and malnutrition in affected patients. This situation worsens overall functional capacity, contributing to and exacerbating the frailty syndrome.

Warning signs and symptoms for which you should consult a doctor:

  • Refusal to eat or drink. 
  • Rejection of certain foods. 
  • Fear of eating alone. 
  • Recurrent respiratory infections. Fever spikes of unknown origin. 
  • Weight loss. Loss of muscle mass. 
  • Spatial disorientation..
  • Facial paralysis or reduced sensitivity. 
  • Drooling. 
  • Inadequate lip closure. 
  • Very slow swallowing and chewing. 
  • Presence of food residues on the tongue or in the mouth. 
  • Food residues coming out through the nose or tracheostomy. 
  • Sensation of food getting stuck in the throat and the need to swallow several times.

All patients should undergo nutritional screening, and if the result is positive, a comprehensive nutritional assessment should be carried out.

Adapting the texture and viscosity of foods in patients with oropharyngeal dysphagia (OD) is one of the treatments and, in many cases, the only one. A multidisciplinary approach is essential in the diagnostic process, as well as in the treatment and overall management of the patient in order to achieve the objectives of the rehabilitation programme, which ultimately are to attain an adequate state of nutrition and hydration and to prevent respiratory complications.