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Dysphagia in Teens & Adults

[Editor’s note: The NFOSD would like to thank Ms. Nancy Swigert for volunteering her time to develop this article on swallowing disorder basics for teens and adults.]

ADOLESCENTS

If swallowing problems are present in teenagers, it is typically a continuation of feeding/swallowing problems the teen presented with as a younger child. Teens with developmental disabilities or chronic conditions, like cerebral palsy, may continue to present with swallowing problems throughout their life.

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Dysphagia Support in Pakistan: Illuminating the Path of Awareness and Care

Shifa International Hospital and NFOSD:

Pioneers of Dysphagia Support in Pakistan,

Illuminating the Path of Awareness and Care


Written By Faiza Badar, Manager Rehabilitation Department

Shifa International Hospital

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Unidentified Causes of Dysphagia

WHAT ARE NEXT STEPS WHEN THE CAUSE OF DYSPHAGIA HASN’T BEEN IDENTIFIED?

Dysphagia can be exhibited in many ways: coughing, choking, feeling like food is sticking, difficulty or pain with swallowing, bringing food back up, and others.  Sometimes the dysphagia is accompanied by, or can cause, changes in overall health, like weight loss or changes in lung health.    Sometimes the cause of these dysphagia symptoms is obvious, such as when a person has a neurological disease (e.g. Parkinson’s, dementia), has experienced a traumatic episode (e.g. stroke, head injury), or has head and neck cancer.

However, sometimes the symptoms of dysphagia cannot easily be tied to an obvious cause, and therefore no treatment plan can be developed. When that happens, it can be very frustrating and you may feel abandoned by the medical team. What steps can you take if you find yourself in that situation?

  1. Do some research on your own on the web to see if there is any information about swallowing symptoms similar to yours.  Be sure you are reviewing information on reputable sites, such as the Mayo Clinic, medicinenet.com, WebMD, etc.  
    • Take good notes on what you read and list the site(s) where you found the information.
  2. Make note of anything you do, or any circumstances, that make the problem better or worse.
    • Better or worse at certain times of the day or night?
    • Relieved or made worse when eating or drinking certain foods?
    • Better or worse when sitting, standing or lying down?
  3. Meet with a member of your medical team, share all of this information,  and pose a series of questions:
    • Review all of your medications (prescription and over-the-counter) with the medical professional and ask if any of those medications might be contributing to your symptoms.
    • Be sure the medical professional is aware of any other medical problems you are having, or have had in the past. Some of these problems might not seem obviously related to your current symptoms, but relationships like that aren’t always clear. For example:
      • ‘Indigestion’ might not seem related to a feeling of a lump in the throat, but the indigestion might be reflux and that feeling of a lump in the throat is likely related.
      • Feeling strain when talking or having a persistent cough might not seem related to pain with swallowing, but it could be.
    • Are there any other diagnostic tests that are indicated to gain more insight into the problem?
    • What are those tests and what further information might be gained?
    • Has the medical professional ever seen another person who presents with symptoms similar to yours?
    • Is there another medical professional you should consult?
    • If you are very anxious about your problem, discuss how anxiety can make certain symptoms worse.
  4. Seek out an assessment at a multi-disciplinary swallowing center. This might be called a Swallowing Center, Swallowing Clinic, Voice and Swallowing Center or Dysphagia Center. Because dysphagia symptoms may seem like they are occurring in one part of the body, but actually originate in another, a multi-disciplinary team that can be found at these centers is often indicated to take a holistic look at the presenting problem.  These specialized centers are usually affiliated with large university systems and would ideally include professionals from specialties such as:
    • Neurology
    • Gastroenterology
    • Otorhinolaryngology
    • Speech-Language Pathology (one with Board Certification in Swallowing). You can check the website of the American Board of Swallowing and Swallowing Disorders to find such a professional: https://www.swallowingdisorders.org/

If you need any assistance finding a specialist, you can reach out to the NFOSD at info@nfosd.com. Our medical advisory board can help provide referral information for the most appropriate specialist.



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Dysphagia & Patients with Tracheostomy and Mechanical Ventilation

What is a tracheostomy?

A tracheotomy is a procedure where an opening is created in the neck and into the airway (trachea) and a tracheostomy is the resulting stoma (hole) that is created.  A tracheostomy tube is typically placed into the stoma to allow for direct access to the trachea for breathing and removing secretions from the airway and lungs.  The tube enables air to flow directly through the trachea rather than through the nose and mouth, bypassing the upper airway.

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Deciphering Dysphagia

Byline: Tiffany Turner, MS, CCC-SLP, Owner, Swallowing and Neurological Rehabilitation, www.tulsasnr.com. Tiffany founded a dysphagia focused outpatient center in 2014 to serve the northeastern Oklahoma region and fill a gap in her community, as she feels adult speech pathology services are often misunderstood and underutilized. She is also an author and publishes resources for other SLPs to use with their patients which have been downloaded by over 2,000 speech-language pathologists worldwide.


Dysphagia, or difficulty swallowing, affects up to 15 million adults in the United States. According to past publications, 1 in 25 people will experience some form of dysphagia in their lifetime, including 22% of those age 50 and older (ASHA, 2008; Bhattacharyya, 2014). People at the greatest risk for swallowing impairments include individuals who have had strokes, those with neurological conditions (such Parkinson’s disease), survivors of head and neck cancer, and the elderly. Despite the significant prevalence of dysphagia, this medical condition is often neglected, and many sufferers are never properly diagnosed or treated.

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Treating Gastroesophageal Reflux Disease

Background

Gastroesophageal reflux is the backflow of acid from the stomach into the esophagus. This occurs when there is a relaxation of the valve that connects the stomach and the esophagus, which is called the lower esophageal sphincter. When reflux occurs, it can sometimes cause inflammation of or damage to the esophagus lining, which is referred to as esophagitis or erosive esophagitis. For some people, reflux can lead to a diagnosis of Barrett’s esophagus.

Barrett’s esophagus is when the lining of the esophagus changes to look like the lining of the stomach, which can lead to cancer in a small number of patients, but for most patients, reflux is not this severe. Reflux is, however, the leading cause of solid food dysphagia.

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