Dysphagia Flashcards
What is the definition of dysphagia?
- difficulty chewing or swallowing
How common is dysphagia?
- 1/3 of residents in long term care have difficulty in swallowing solid oral dosage forms
- GERD is also a risk factor
- intermittent dysphagia was associated with anxiety, while progressive dysphagia was associated with depression
Who must diagnose dysphagia?
- an SLP
How does a pharmacist assess dysphagia?
- evaluate drug related causes of dysphagia
- suggest treatments for xerostomia
- modify time of administration of dodge form and make medication recommendations to minimize, eliminate or adapt to dysphagia where appropriate
What are the three phases of swallowing?
- Oral Phase
- Pharyngeal Phase
- Esophageal Phase
Describe the oral phase of swallowing
- food is chewed and missed with saliva to form a bolus
- voluntary swallowing is initiated and the tongue pushed the bolus posterior towards the pharynx, stimulating several receptors to start the swallowing response
Describe the pharyngeal phase of swallowing
- the swallowing response stops the breathing and raises the larynx for the bolus to pass
- the bolus is transported by peristalsis across the closed vocal folds and epiglottis into the esophagus through the cricopharyngeal sphincter
Describe the esophageal phase of swallowing
- peristalsis drives the bolus through the lower esophageal sphincter into the stomach
What are the main causes of dysphagia?
3 main sources that may place a person at risk:
- neurological
- physical/structural disease or injury
- psychogenic conditions
What are the different neurological cases that can cause dysphagia (acquired after birth)?
- stoke
- head trauma
- polio
What are the congenital neurological cases that can cause dysphagia?
- cerebral palsy
- ringed esophagus
- musculoskeletal abnormalities at birth
- metabolic disturbances ar birth
- internal organ deformities at birth
- genetic disorders
What are the degenerative neurological causes of dysphagia?
- ALS
- Parkinson’s disease
- Huntington’s disease
- MS
- Dementias
What are some of the physical/structural disease or injury reasons for dysphagia?
- trauma
- poorly fitting dentures
- gum disease, mobile teeth or decayed teeth
- disease (cancer, surgery)
- generalized weakness
What are the psychogenic reasons for dysphagia?
- emotional disturbances
- developmental delay
- medication induced
- psychiatric diagnosis
What are the oral stage symptoms of dysphagia?
- poor lip closure
- drooling or excessive secretions
- seepage of food or liquid from the mouth
- reduced chewing ability
- pocketing or food on the weak side
- reduced tongue function
- dry mouth
- food and liquid residue remains on the tongue/roof of the mouth
- increased time to complete a meal safely and enjoyably
- fatigue as the mean progresses
- poor dentition or poorly fitting dentures
