Both with solids and liquids. Suffering from oropharyngeal dysphagia is synonymous with getting angry every day. Do you know the reality that patients who suffer from it face?
The dysphagiagenerally speaking, it is nothing more than that difficulty that some people have to swallow. Depending on the area where this complication occurs, it will be called dysphagia esophageal, competence of the digestive doctor; i oropharynxof otorhinolaryngologists.
EFEsalut spoke with the doctor Magdalena Pérez Ortín and Dr. Pedro Cabrera, members of the Laryngology, Voice, Phoniatrics and Swallowing Commission of the Spanish Society of Otorhinolaryngology and Head and Neck Surgery (SEORL-CCC)to deepen the oropharyngeal dysphagiaa pathology frequently confused with simple boredom.
Why does this condition occur?
There are many factors that cause or can cause this type of dysphagia. Doctor Pérez Ortín indicates that this pathology can be presented by:
- Other diseaseshow can they be…
- Neurological diseases: due to lack of coordination.
- Respiratory tract infections that inflame or affect the area.
- Prolonged hospital admissions: Before a complicated surgery or any accident.
- age: this is a very important risk factor. Generally, from the age of 65, muscle deterioration is important, so swallowing becomes quite a challenge in many cases.
- Structural alterations: such as having a tumor or any injury in the area.
To this list, Dr. Pedro Cabrera adds a gastric disease, the pharyngo-laryngeal reflux. And the passage through the larynx of this acid from the stomach inflames the area and makes it difficult to swallow.
What are the symptoms?
How can we identify oropharyngeal dysphagia? Dr. Magdalena Pérez Ortín recounts her classic symptoms:
- Coughing or gurgling at lunchtime
- Phlegm, colds
- Unintentional weight loss: due to malnutrition or dehydration
- Fever in the afternoons
- Voice changes when eating: a wet, different voice
- Frequent choking
The specialist indicates that the symptoms will always depend on the starting point of each patient. Because it doesn’t always manifest itself in the same way.
“The cough is not always present. There are patients with neurological diseases who lose the cough reflex”, explains doctor Pérez Ortín.
The day to day of the disease
Beyond symptomatology, risk factors and the reasons why it occurs, one of the main defining factors of dysphagia is the way in which conditions the lives of those who suffer from it.
Because the lives of those affected are complicated: when we think of inability to swallow, we imagine the classic nausea. But this pathology is much more than just that.
“Everything is sucked in, not only solids, but also liquids,” says the doctor.
Moreover, the liquid itself requires more effort, more coordination, so it is the most difficult to swallow.
The problem faced by patients with this pathology is none other than the biggest propensity for recurrent pneumoniaas food or liquids pass through the airways.
In fact, according to the expert, it is assumed that 50% of the times that this food passes through the air in sufficient quantity, it will produce an infectious disease.
Pérez Ortín defines it as a constant choking, which, although it may have a critical moment, generally happens continuously and with the minimum. It is a chronic thing, not a one-time thing.
How is oropharyngeal dysphagia treated?
The question that arises in front of this panorama is simple: how do you live with the disease? There is treatment, but this will always depend on the reason for the dysphagia. If it is due to…
- Neurological causes: like a stroke or Parkinson’s, the treatment is that of the disease itself.
- A nuisance, as can be a problem in a vocal cord: the treatment is surgical.
- reflux: if it is due to reflux, stomach protectors will be used.
On the other hand, depending on the degree of dysphagia and the consequences it has on the patient, a modification of the diet will be discussed.
- Know the consistencies that are tolerated: tests are done to check the patient’s tolerance.
- Prescribe thickeners so that the patient can take liquids without any risk.
- Nutritional supplements: in case of malnutrition due to the difficulty in swallowing, a vicious circle is presented to us because if it does not have the necessary nutrients, the responsible muscles weaken. That is why it is necessary in certain cases. prescribe nutritional supplements.
Something that is always resorted to in terms of treatment is the rehabilitation with speech therapy. The use of techniques and mechanisms for swallowing is vitally important in these cases. It is clear that it is not so simple to do rehabilitation.
“There is no speech therapy to rehabilitate these patients,” assures Dr. Cabrera.
This specialty is completely neglected in public hospitals, and the patients who need this care are the main victims of all this.
In one way or another, SEORL-CCC members talk about generic guidelines that can be applied to anyone:
- Posture while eating: feet on the ground, to have enough strength to pass the food bolus. Sitting in a chair, straight forward, at a table.
- Conscious eating: without distraction, with pause.
- Don’t talk while eating: It’s not just about education, it’s about safety. It’s a risk.
“These are general recommendations. If you have a good habit from a young age, it is easier to continue it when you are older”, says Magdalena Pérez Ortín.
The message conveyed by the expert is clear: the importance of education from an early age with regard to nutrition will make a difference tomorrow.