What is Dysphagia?

This article provides a brief overview of what dysphagia is. Please note that the article contents covered, such as symptoms, causes and treatments, is non-exhaustive and not intended to replace education and training.

If you are interested in learning how to help those experiencing dysphagia, we recommend undertaking dysphagia training.

Dysphagia (Difficulty Swallowing)

Dysphagia is the medical term for difficulty swallowing.  Our capacity to eat and swallow varies over our lifetime and can be influenced by a number of factors including age, physical and mental conditions and behavioural factors. However, dysphagia is not restricted to issues with swallowing food, it extends to any swallowing issues including problems with drinking, chewing, eating, controlling saliva, or taking oral medicines.

The intensity of this condition can vary from mild and occasional difficulty while swallowing, to painful or ongoing irritation. In some instances, those affected by more severe dysphagia are completely unable to swallow.

Symptoms

Dysphagia (difficulty swallowing) can present with various symptoms including long-term symptoms like weight-loss. Immediate symptoms of dysphagia, which may be experienced while eating or drinking, include:

• Feeling unable to swallow
• Pain during swallowing
• Gagging or choking when eating or drinking
• Food or drink becoming stuck in the throat or going down the ‘wrong way’
• A feeling of food being stuck in the throat, chest or behind the breastbone
• Excessive coughing or throat-clearing during eating and drinking
• Shortness of breath whilst eating and drinking
• Drooling
• Wet-sounding voice when eating or drinking
• Food returning through the nose
• Regurgitation (food coming back up)

Long-term or adaptive symptoms of dysphagia include:

• Extended meal times (more than 30 minutes to complete a meal)
• Avoidance of certain foods due to swallowing difficulties
• Frequent heartburn
• Food or stomach acid backing up into the throat
• Hoarseness
• Weight loss
• Common coughing or throat clearing, typically after meals

When to Call a Doctor

A one-off incidence of dysphagia, such as food becoming stuck in your throat during a meal, is not often an immediate call for concern.

However, if you, or someone you know, is experiencing recurring issues and want to better understand what dysphagia is, schedule an appointment with your healthcare provider as soon as possible.

In some instances, difficulty swallowing may result in an inability to breathe, or be a symptom of an oncoming stroke. If you, or someone you know, is having sudden and significant trouble breathing due to dysphagia, call 000 and seek immediate assistance.

What are the Main Types of Dysphagia?

Oral dysphagia (Mouth)

Oral dysphagia is a type of dysphagia that occurs at the start of the swallowing process. In these instances, your mouth struggles to prepare the food to be swallowed correctly. This includes issues with the jaw, teeth and tongue not breaking down food effectively, or the salivary glands producing an inadequate or excessive amount of spit.

Oropharyngeal dysphagia (Throat)

Oropharyngeal dysphagia (also known as “high” dysphagia or transfer dysphagia) refers to trouble swallowing that stems from the throat. In this instance, throat muscles may be weakened, increasing the difficulty of transferring food effectively. In those not experiencing dysphagia, the voice box (larynx) open and closes as necessary to ensure that food or liquid does not “go down the wrong way” (slip into your airway (trachea)).

Esophageal dysphagia (Esophagus)

Esophageal dysphagia (also known as “low” dysphagia) refers to trouble swallowing that occurs lower down, in the base of the throat or deeper in the chest. The cause of dysphagia in this instance stems from the body of the esophagus, lower esophageal sphincter, or cardia of the stomach.

Risk Factors

Age-Related Factors

• Advanced age: The risk of dysphagia increases significantly in individuals over 50 years old, with prevalence estimates ranging from 15% to 22% in community-dwelling adults.
• Natural aging processes: Changes in muscle mass, connective tissue elasticity, and sensory acuity can contribute to swallowing difficulties.

It’s important to note that while aging is a significant risk factor, dysphagia is not an inevitable consequence of normal aging. The presence of age-related diseases and health complications plays a crucial role in the development of clinically significant dysphagia in elderly individuals.

Medical Conditions

• Neurological disorders: Stroke, Parkinson’s disease, dementia, multiple sclerosis, and brain injuries
• Muscular disorders: Myasthenia gravis, muscular dystrophy, and polymyositis
• Structural issues: Zenker’s diverticulum, esophageal strictures, and tumors
• Respiratory conditions: Chronic obstructive pulmonary disease (COPD)

Lifestyle Factors

• Smoking
• Obesity
• Excessive alcohol consumption

Medical Interventions

• Presence of a tracheostomy
• Use of ventilators
• Nasogastric tube placement
• Certain medications (e.g., anticholinergics, sedatives, antidepressants)

Other Factors

• Pregnancy
• Hiatal hernia
• Scleroderma
• Recent anterior cervical spine surgery

Dysphagia Complications

Dysphagia can lead to several serious complications if left untreated, including:

• Aspiration and Aspiration Pneumonia: Food, liquids, or saliva may enter the airway (aspiration), potentially causing lung infections such as aspiration pneumonia.
• Choking and Breathing Troubles: Difficulty swallowing can result in food or liquids blocking the airway, leading to choking, which can be life-threatening.
• Malnutrition and Dehydration: Avoidance of eating or drinking due to fear of choking or swallowing difficulties can result in inadequate nutrition and fluid intake, leading to malnutrition and dehydration.
• Reduced Quality of Life: Dysphagia may cause embarrassment, ongoing discomfort, social isolation, and a loss of enjoyment in eating and drinking, impacting overall well-being.
• Food Impaction and Esophageal Perforation: Severe cases of esophageal dysphagia may result in food becoming lodged in the esophagus (impaction), which can lead to esophageal perforation, sepsis, or even death.

These complications highlight the importance of knowing what dysphagia is, early diagnosis and appropriate management to prevent potentially life-threatening outcomes.

How Can Dysphagia be Prevented?

There is no way to completely prevent dysphagia. To lower your risk of developing ongoing dysphagia it is recommended that you take part in a healthy lifestyle including healthy eating, drinking and smoking habits.

To reduce the risk of experiencing once-off or sudden dysphagia it is recommended to eat slowly and chew well.

Provide Support to Those Experiencing Dysphagia

It only takes one day to enhance your skills in supporting individuals with swallowing difficulties. At Bestwest Care we offer a specialised dysphagia training course to help Perth healthcare professionals, aged care workers, nursing students, and caretakers extend their support to those impacted by dysphagia. By completing the course you will be equipped with the essential skills to:

• Knowledge and skills in providing physical assistance with feeding
• Knowledge and understanding in identifying choking and aspiration
• Implement safe feeding techniques for those with swallowing difficulties
• Accurate client positioning
• Reporting and documentation, policies and procedures

Designed to be an accessible course suitable industries and community groups, there are no prerequisites for enrollment. Dysphagia training is held at Bestwest Care Training Rooms, or can also be conducted at individual workplaces or venues if minimum numbers and appropriate facilities are available.

LIMITED SPOTS AVAILABLE

Please note that positions for our Perth dysphagia course are limited. If you are interested in learning more about the course, please visit our dysphagia training & management course page. We offer dysphagia training as a unit of competency or as a non-accredited course alongside our full range of Certificate III and Certificate IV courses for the aged and disability care sectors.