People suffering from dysphagia have trouble swallowing. Some people may experience problems swallowing foods, liquids or saliva, some may find it painful to swallow and others are unable to swallow at all. These swallowing difficulties mean it is a challenge for sufferers to eat or drink sufficiently well to maintain healthy nutritional levels. There are two types of dysphagia - high or oropharyngeal dysphagia and low or oesophageal dysphagia. High dysphagia occurs when the swallowing difficulties arise in the mouth or throat. It is not uncommon to find high dysphagia in stroke victims. In low dysphasia the problem arises in the oesophagus, sometimes caused by cancer surgery or infections. There are many causes of dysphagia, stroke being one of the more common. The condition can occur when any of the muscles, nerves or passageways used during the complicated swallowing process are not working properly. For example, amongst patients who experience a stroke dysphagia can result from reduced co-ordination of the mouth and throat muscles. Other neurological causes include Parkinsons disease, cerebral palsy, motor neurone disease and multiple sclerosis. Sometimes the condition is caused by the throat and the oesophagus narrowing or being obstructed. This can be as a result of lung or mouth cancer, radiotherapy, a cleft lip and palate, gastro-oesophageal reflux disease (GORD), or infections. Health conditions affecting the muscles used for pushing food through the oesophagus to the stomach can also cause dysphagia. These conditions include achalasia, where the oesophageal muscles stiffen too much to enable food or liquid to pass through to the stomach; and scleroderma, where healthy tissue comes under attack from the immune system and leads to the muscles in the throat and oesophagus stiffening. The condition can simply be as a result of aging, when the mouth and throat muscles used to swallow become weaker. Dysphagia is more common amongst elderly people but treatment is readily available for age-related dysphagia. It is important to discover why the patient has developed the problem in order to formulate an effective treatment plan. The most common cause is stroke dysphagia. Many patients find that liquid medicines and food can help to ease the problem after a stroke. There are exercises that can be done to improve swallowing ability but in persistent cases sometimes a feeding tube may be required. If dysphagia is so acute that the patient cannot swallow even liquid medication and food stuffs then a temporary or permanent feeding tube may have to be inserted. This is a final measure if alternative treatments are not effective. Before this stage is reached, reducing the size of food mouthfuls, chewing more thoroughly, adding liquid to the food or liquefying food can all help to ease swallowing. Remaining calm can also assist, as many patients become distressed when experiencing difficulty, thus exacerbating the problem. Symptoms of dysphagia include being unable to swallow or finding swallowing painful. Sometimes sufferers bring food back up, cough or choke whilst trying to swallow or experience the sensation of food being stuck in the throat or chest. Sufferers can experience unexplained loss of weight and develop repeated lung infections. Dysphagia can lead to complications and associated illnesses. For example, patients with high dysphasia are vulnerable to a lung infection known as aspiration pneumonia which occurs when a piece of food gets into the lungs. This happens when the damaged muscles fail to close the larynx during swallowing, leaving the passageway to the lungs open. Other problems include the weakened oesophageal wall enabling a pocket to develop outside the oesophagus, trapping some swallowed food which can then lead to the food returning to the throat when the patient is sleeping or lying down. Severe weight loss is also a problem, sometimes caused by the oesophagus being too narrow. Food sticks in the oesophagus and obstructs other food and even liquids from reaching the stomach. There are a variety of treatments for dysphagia, ranging from exercising muscles and changing eating habits to surgery. For many sufferers of dysphasia and stroke victims, surgery is not necessary and the condition can be managed and treated. For example, some victims of stroke and dysphagia find that exercising muscles improves strength and co-ordination for swallowing. If you are having trouble swallowing pills there are some options available. First of all find out if there are different versions of your drug available, there is sometimes the option of a liquid medicine, a dispersible, buccal or an oro-dispersible tablet. Some medicines are only available when prescribed by a doctor, as they do not have a licence to be sold by a pharmacist. Consult a pharmacist though and they will be able to give you any information you need on this matter.
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