Dysphagia, or failures with swallowing, can range from mild to severe, acute to chronic, and short- to long term. It can result in unintentional weight loss, malnutrition and dehydration, social and psychological challenges, complications with other conditions, and, more seriously, life-threatening problems like choking, suffocation and lung infections or pneumonia.
The most common form is oropharyngeal dysphagia – difficulty with the reflexive act of swallowing itself which involves moving food or liquid from the mouth through the pharynx and into the oesophagus. The other main type is oesophageal dysphagia, which produces the feeling of food being stuck in the throat or chest and possibly chest pain.
The most frequent causes of dysphagia are neurological disorders including stroke, dementia and Parkinson’s disease. Other triggers include head injury, motor neuron disease, depression, chronic obstructive pulmonary disease, frailty, cancer and postoperative problems involving the head and neck. Weakened muscles and sarcopenia can also impact swallowing. Pills themselves – which 40% of adults find hard to swallow – can cause dysphagia through medication side effects.
It is very important to identify swallowing problems and their cause as early as possible. People who have experienced stroke are at high risk and should be immediately screened for swallowing problems before ingesting anything. People with other high-risk medical conditions as outlined above should be asked if they have experienced any issues with swallowing.
Apart from obvious difficulties, other signs to look for include coughing before swallowing, during or after eating, heartburn or reflux, drooling, frequent chest infections, storing food in the cheeks, taking a long time to eat, or reluctance to eat or swallow anything. Changes in facial features, speech or voice, like slurring or gurgling, could indicate silent aspiration. Family members should look for these signs and seek professional help if concerned.