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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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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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Achalasia

By Dr. Michael Vaezi, MD, PhD, MS, Clinical Director of the Center for Swallowing and Esophageal Disorders at Vanderbilt University Medical Center. Dr. Vaezi also serves as on the Medical Advisory Board for the Achalasia Foundation.

Background:esophagus

Achalasia, a rare condition affecting about 1 in every 100,000 individuals each year, is defined as a disorder of the esophagus in which the band of muscle located where the esophagus and stomach meet fails to function properly. This muscle is called the lower esophageal sphincter (LES) and it typically relaxes when a person swallows. However, in people diagnosed with achalasia, the LES does not fully relax and the normal muscle activity of the esophagus is reduced. Therefore, food is not properly moved through the esophagus to the stomach. Classic symptoms of this disorder include difficulty swallowing foods and/or liquids (dysphagia), as well as regurgitation of undigested foods and saliva. Additional symptoms may include substernal (esophageal) chest pain during meals, significant or rapid weight loss, and significant reduction in overall quality of life. Achalasia occurs equally in men and women, typically between the ages of 30 and 60, has no racial predictor, and does not run in families.

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Phagophobia: The Fear of Eating

Written by Liza Blumenfeld, MA, CCC-SLP, BCS-S

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Every human has experienced the uncomfortable sensation of choking. For many, it is a sporadic event that passes without much thinking. A loved one may offer a reminder to “slow down” or “not talk with your mouth full”. Unfortunately, for some, the fear of swallowing is an all-encompassing emotion that can render the act of eating as joyless. A small percentage of these individuals bear this burden while being told that their symptoms are essentially baseless. In other words, they are told it is all in their heads.

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