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Dysphagia

Difficulty swallowing.

PubMed Health Glossary
(Source: NIH - National Cancer Institute)

About Swallowing Difficulties in Neurological Disorders

Having trouble swallowing (dysphagia) is a symptom that accompanies a number of neurological disorders.

The problem can occur at any stage of the normal swallowing process as food and liquid move from the mouth, down the back of the throat, through the esophagus and into the stomach.

Difficulties can range from a total inability to swallow, to coughing or choking because the food or liquid is entering the windpipe, which is referred to as aspiration. When aspiration is frequent a person can be at risk of developing pneumonia. Food may get "stuck" in the throat or individuals may drool because they cannot swallow their saliva.

Neurological conditions that can cause swallowing difficulties are: stroke (the most common cause of dysphagia); traumatic brain injury; cerebral palsy; Parkinson disease and other degenerative neurological disorders such as amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig's disease), multiple sclerosis, progressive supranuclear palsy, Huntington disease, and myasthenia gravis. NIH - National Institute of Neurological Disorders and Stroke

What works? Research summarized

Evidence reviews

Dysphagia occurs frequently in Parkinson's disease although patients themselves may be unaware of swallowing difficulties. Speech and language therapists in conjunction with nurses and dietiticians use techniques that aim to improve swallowing and reduce the risk of choking and chest infections.

This review compared the benefits of swallowing therapy versus placebo (sham therapy) or no therapy for swallowing disorders in Parkinson's disease. Relevant trials were identified by electronic searches of 21 medical literature databases, various registers of clinical trials and an examination of the reference lists of identified studies and other reviews.

Botulinum toxin for swallowing disorders

Many people have problems swallowing because of an impairment of the upper oesophageal sphincter (UOS), a high pressure zone within the tube that carries food from the mouth to the stomach. Many people with neurological conditions such as stroke, traumatic brain injury, Parkinson's disease or multiple sclerosis can have UOS impairment. This results in difficulty swallowing food and liquids, resulting in choking and food entering into the lungs (aspiration). This has serious consequences for the patient and can cause dehydration, malnutrition and aspiration pneumonia. The person's quality of life can be affected as they are unable to have food or liquids safely by mouth. Tube feeding and hospitalisation is often required.

Acupuncture for dysphagia in acute stroke

Better designed clinical trials are needed to prove whether acupuncture is effective for treating swallowing difficulties in patients with stroke. Patients who have swallowing difficulties (dysphagia) as a result of their stroke are less likely to survive and be free of disability than stroke patients who can swallow normally. Acupuncture is commonly used to treat this complication in traditional Chinese medicine practice. We systematically reviewed currently available evidence for the use of acupuncture in treating swallowing difficulties after acute stroke. Only one small randomised controlled trial was identified, involving 66 participants, which did not provide clear evidence of benefit from adding acupuncture to standard Western medical treatment. Considering the small sample size and methodological imperfections, there is insufficient evidence to determine the effectiveness of acupuncture. More research is needed.

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Summaries for consumers

Dysphagia occurs frequently in Parkinson's disease although patients themselves may be unaware of swallowing difficulties. Speech and language therapists in conjunction with nurses and dietiticians use techniques that aim to improve swallowing and reduce the risk of choking and chest infections.

This review compared the benefits of swallowing therapy versus placebo (sham therapy) or no therapy for swallowing disorders in Parkinson's disease. Relevant trials were identified by electronic searches of 21 medical literature databases, various registers of clinical trials and an examination of the reference lists of identified studies and other reviews.

Botulinum toxin for swallowing disorders

Many people have problems swallowing because of an impairment of the upper oesophageal sphincter (UOS), a high pressure zone within the tube that carries food from the mouth to the stomach. Many people with neurological conditions such as stroke, traumatic brain injury, Parkinson's disease or multiple sclerosis can have UOS impairment. This results in difficulty swallowing food and liquids, resulting in choking and food entering into the lungs (aspiration). This has serious consequences for the patient and can cause dehydration, malnutrition and aspiration pneumonia. The person's quality of life can be affected as they are unable to have food or liquids safely by mouth. Tube feeding and hospitalisation is often required.

Acupuncture for dysphagia in acute stroke

Better designed clinical trials are needed to prove whether acupuncture is effective for treating swallowing difficulties in patients with stroke. Patients who have swallowing difficulties (dysphagia) as a result of their stroke are less likely to survive and be free of disability than stroke patients who can swallow normally. Acupuncture is commonly used to treat this complication in traditional Chinese medicine practice. We systematically reviewed currently available evidence for the use of acupuncture in treating swallowing difficulties after acute stroke. Only one small randomised controlled trial was identified, involving 66 participants, which did not provide clear evidence of benefit from adding acupuncture to standard Western medical treatment. Considering the small sample size and methodological imperfections, there is insufficient evidence to determine the effectiveness of acupuncture. More research is needed.

See all (31)

More about Dysphagia

Photo of an adult woman

Also called: Swallowing disorder, Dysphagic

Other terms to know:
Gastrointestinal Tract (GI Tract)

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