Swallowing Disorders

Heather Lazarides, MS, CCC-SLP, BCS-S, CKTP+, describes dysphasia, or a swallowing disorder. She tells what can cause a swallowing disorder, what the symptoms are, and how they can be treated.


What causes swallowing disorders?

The word that us medical professionals use for swallowing disorders is dysphasia. Several things can cause dysphasia, anything from a disease process such as Parkinson's or ALS to a respiratory disease such as COPD. Simple things like being intubated for an easy surgery can cause a dysphasia after the fact. Head and neck cancer can cause swallowing disorders. There are several facets that can cause swallowing disorders. The most common one tends to be with strokes or dementia as people get older.

What are some symptoms of swallowing disorders?

People might start noticing that they are coughing throughout their meals more. They're noticing that they have that gurgly underwater sounding voice. Another thing that can give you a hint that maybe your body is telling you, "Hey, we have a problem here!" is weight loss or not consuming as much food as you would like to throughout a meal, which can lead to becoming malnourished or dehydrated.

How do you treat swallowing disorders?

Speech pathologists have several treatment approaches that we will tailor to exactly whatever your disorder is. There are lots of things that can go wrong in this seemingly simple response. Traditionally, we would first have you do some kind of formal swallowing test, and there are two tests that are both considered a gold standard that we do here at the hospital. The first one is a fiber optic endoscopic evaluation of swallowing. We might call it FEES for short. That involves us just putting a tiny camera with a light into your nose, down to your throat, so we can see what's going on. Then, we'll give you food. There's another test that's an X-ray that is performed in radiology that also shows exactly what's going wrong with your swallowing. Now after we get those results, we can actually plan a treatment around what your deficit is. That might be a swallowing exercise program just like you would think of for physical therapy. We do exercises for those swallowing muscles. Also, we'll do electric stimulation to your throat muscles to help get them stronger and to help produce a muscle reaction. We can do feedback where people can actually look at a screen and show how hard or how good their muscles are working. That provides some feedback. I do some manual or massage therapy. If you think of a muscle that's too tight in your shoulder that doesn't want to work, that's the same with your tiny little swallowing muscles, so there is quite an array of things that we can do.

How long can patients expect to be in therapy for swallowing disorders?

It depends on the disorder. If I get somebody who had radiation or surgery to their head and neck, they're projected course of therapy might be quite a bit longer because they have a lot of changes within their tissue through the radiation and surgery, whereas if someone just comes with some COPD and coughing that is a newer dysphasia onset, we can generally get these people feeling back to normal and eating and swallowing safely within two months or so.