Dr. Carlos Pollán and Dr. Jennifer Knäpper are part of the Otorhinolaryngology Unit of Dr. Jordi Coromina. They are responsible for the Dysphagia Unit (swallowing disorders) at the Hospital Quirón Teknon in Barcelona.
Swallowing is the passage of food from the mouth into the esophagus. It involves rapid coordination of the structures involved (mouth, pharynx, larynx and upper esophagus), whose movements are directed by the nervous system.
When there is difficulty in swallowing a solid or a liquid, we say that the patient has a swallowing disorder or dysphagia.
What are the causes?
There are many diseases that can produce a swallowing disorder. For example, those of the nervous system, which acts as a coordinator of the process: stroke (cerebral vascular accident), dementia, Parkinson’s disease, infantile cerebral palsy, multiple sclerosis, and cranioencephalic trauma (generally due to traffic accidents). On other occasions the problem will lie in the oral cavity (absence of teeth, alterations of the tongue, tumors), or in the esophagus.
How are swallowing disorders diagnosed?
First of all, it is essential to have a good interrogation of the patient or, in the case of children or adults with communication difficulties, with their relatives.
Then, in the same consultation, we will perform an endoscopy, a quick and painless test, which will allow us to perfectly visualize the mouth, the pharynx and the entrance of the esophagus. If after the endoscopy we suspect that the cause is in other areas of the digestive tract, we will coordinate the case with the corresponding specialist (digestologist and/or digestive endoscopist).
During the visit, the otorhinolaryngologist will ask the patient about the discomfort he/she has when swallowing, when he/she started noticing the symptoms, and if they have worsened over time. It will be important to detect if he/she presents coughing, food stagnation, the need to swallow several times, drooling, chewing problems, or choking and choking during swallowing.
After questioning and endoscopy, we will perform the so-called “dysphagia test”, which consists of asking the patient to swallow different foods, first liquids and then solids, while we observe on a video screen how he/she swallows them, thus identifying the cause of the problem. We will look at what type of food, what viscosity, what volume and what position are safest for the patient to swallow correctly.
Is there a treatment?
Yes, logically the treatment will depend on the cause and the age of the patient (child or adult). According to the examinations performed, an individualized adaptation of the diet will be made, in collaboration with a specialist in nutrition.
In addition, rehabilitation treatment will be necessary, together with a speech therapist specializing in swallowing, establishing postural changes and specific maneuvers to swallow correctly.
Early diagnosis and treatment will prevent various complications such as malnutrition, dehydration and aspiration pneumonia.