By definition dysphagia is “difficulty or discomfort in swallowing, a symptom of a disease.”
It is estimated approximately 15 million Americans are impacted by this disorder. The Agency for Health Care Policy and Research and (ASHA) provides a fact sheet with the statistics: over 60,000 Americans die each year due to problems or complications of dysphagia; aspiration pneumonia is one of the main causes of death. Patients with degenerative neuromuscular diseases and strokes are particularly susceptible.
What Is Dysphagia?
Dysphagia is very serious and common problem with progressive diseases such as Parkinson’s and ALS. It is estimated 90 percent of patients with Parkinson’s or ALS will suffer from dysphagia at some juncture.
It is extremely important the details of the dysphagia are properly diagnosed in order for a medical professional to advise on the proper diet. Each patient is unique and each patient can safely tolerate different consistencies of liquids and foods. Foods may need to be pureed, liquids may need to be thickened or thinned as the condition warrants.
When dysphagia becomes evident a few standard tests are performed to distinguish which foods are appropriate. Depending upon the origin of the symptom, your primary doctor will refer a patient to specialists to determine the course of treatment. These specialists can include: gastroenterologist, otolaryngologist (ENT), neurologist or a speech language pathologist.
Common Swallowing And Dyshagia Tests Include:
Barium Xray: A barium x-ray or barium swallow is a procedure used with special medical imaging to examine the upper gastrointestinal tract. The patient will have to swallow a special substance that is suspended with barium. This is a substance that will show up correctly in x-rays. Sometimes baking soda is added as well to examine the way that gases react. Gas will appear as white patches and the swallowed solution can be examined directly through the x-ray. This is an ideal solution for all patients as x-rays can expose the patient to radiation.
Esophagoscopy aka upper gastrointestinal endoscopy: This allows the doctor to view the esophagus, stomach and top of the small intestine. An endocscope is a thin viewing instrument inserted through the mouth and moved through the gastrointestinal tract.
Endoscopy: This procedure is especially helpful for dysphagia patients who can’t communicate their symptoms or air attends well. An anda scope is essentially a instrument with a camera that’s designed for looking down the esophagus and into the digestive tract. These devices can be inserted to measure digestion visually and with the flexible nature of the Endoscope is possible to see directly into spaces that an x-ray normally wouldn’t be able to. Endoscopy can be performed under sedation or even without sedation and it can be somewhat uncomfortable for the patient.
Dynamic swallowing study: In order to get comparative results to determine what is healthy and what isn’t, dynamic swallowing studies sometimes take place usually using barium xray procedures to help identify swallowing disorders. These are usually voluntary and help doctors to better treat patients with swallowing disorders.
Manometry aka Esophageal muscle test : This test measures the pressure in your esophagus as you swallow. A small tube is placed down your esophagus.
The quality of life of a dysphagia patient is severely impacted and presents many complications: predisposition to choking, malnutrition, dehydration, weight loss and aspiration pneumonia. While many of the swallowing tests are uncomfortable, the results can greatly enhance the quality of life of a dyshagia patient.
Clinical Trial NCT02296528 SED
A clinical trial studying the biomedical device, Swallow Expansion Device (SED) is underway at the University of California. This is a Phase I trial and is currently seeking participants. The SED is an implant which assists with swallowing. The mechanics are further detailed in an article by the National Foundation of Swallowing Disorders which explains the SED in detail and what the trial hopes to accomplish.
Click here for the clinical trial at clinicaltrials.gov.