Swallowing part1

Eating and swallowing are complex behaviors involving volitional and reflexive activities of more than 30 nerves and muscles. They have two crucial biological features: food passage from the oral cavity to stomach and airway protection. The swallowing process is commonly divided into oral, pharyngeal, and esophageal stages according to the location of the bolus. The movement of the food in the oral cavity and to the oropharynx differs between eating solid food and drinking liquid. Dysphagia can result from a wide variety of functional or structural deficits of the oral cavity, pharynx, larynx or esophagus. The goal of dysphagia rehabilitation is to identify and treat abnormalities of feeding and swallowing while maintaining safe and efficient alimentation and hydration.

World Nutrition

Dysphagia – difficulties in swallowing – are a major factor involved in malnutrition in many cases. Nutritionists can benefit from better understanding this complex process. “Comprehensive Management of Swallowing Disorders” by Ricardo L. Carrau, Thomas Murry and Rebecca J. Howell (San Diego, CA: Plural Publishing: 2017) is one of the most comprehensive books on dysphagia. Its contents inform on the nature of swallowing, the etiology of relevant disease, evaluations, diagnosis and interventions for swallowing problems in adults. It could thus be useful for nutritionists and dietitions, pediatricians, occupational therapists, gastroenterologists, otorhinolaryngologists, neurologists, surgeons, speech and language pathologists, and families of patients with swallowing problems. This second edition textbook, which was published in 2017, is divided into seven sections that each address a fundamental knowledge gap, providing a comprehensive foundation from which future treatment innovati...

Anaesthesiology Intensive Therapy, 2020

Swallowing disorders-such as aphagia, odynophagia and dysphagia are increasingly observed among patients in intensive care units (ICU). Aphagia means inability to swallow, and odynophagia means painful swallowing. Their most common causes are inflammatory or neoplastic lesions in the oropharynx, or the consequences of oncological treatment, e.g. radiotherapy [1-3]. Dysphagia is an abnormality in the swallowing process, i.e. ingestion of food, grinding it, and transporting it from the oral cavity through the oesophagus to the stomach. The severity of the pathology may vary depending on the aetiology. It can be caused by structural anomalies in the upper gastrointestinal (GI) tract or functional disturbances of the nervous and/or muscular systems [3]. Both the diagnosis and treatment of dysphagia require the cooperation of specialists in many fields of medicine. It seems that anaesthesiologists should be included in this group [3]. Dysphagia significantly worsens the patients' quality of life. It results in increased morbidity and mortality, mainly due to a higher risk of aspiration and subsequent aspiration pneumonia, as well as to difficulties in the intake of food and/or fluids by mouth, which leads to malnutrition [1]. Diagnosis and determination of the cause of dysphagia is crucial, and in many cases it offers the opportunity to treat and/or compensate for swallowing problems and thus reduce the risk of complications. The final effect of the therapy, however, is

Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale, 2003

Aim of the investigation was to assess the workload and verify the results of oropharyngeal dysphagia management in a large state hospital by means of a descriptive, observational prospective study and descriptive statistical analysis. 81 patients [37 females, 44 males, mean age 61.3 (+/- 13) years] suffering from oropharyngeal dysphagia were evaluated and treated in the in- and outpatient Divisions of the "Azienda Ospedaliera S. Giovanni Battista" in Turin. Treatment of oropharyngeal dysphagia included changes in consistency and texture of food, compensatory postures of head, strengthening exercises for oropharyngeal muscles, and stimulation of pharyngeal sensitivity. In data collection and analysis, the following were used as outcome measures: mode of nutrition delivery (oral, enteral, parenteral), dietary adjustments, presence of aspiration or penetration, and use of compensatory head positioning. Results showed that the number of patients fed by parenteral or enteral t...

Annals of physical and rehabilitation medicine, 2018

Introduction/Background The prevalence of dysphagia in the elderly is high and dysphagia increases the risks of low nutritional status and onset of pneumonia. We have developed the ward rounds to check the swallowing function by using videoendoscopic evaluation of swallowing (VE) for suspected patients with dysphagia (swallowing rounds). The aim of this study was to investigate the effect of swallowing rounds. Material and method Upon requests from ward nurses or clinical departments in our hospital, a full-time certified nurse specialist in dysphagia examined the general condition of patients and performed screening for dysphagia. For patients who required detailed investigations, a transdisciplinary dysphagia care team conducted the swallowing rounds. We reviewed the medical records of 158 patients (mean age 79 years) in whom swallowing rounds were conducted between February and May 2017. The etiology, recommended food and liquid, severity of dysphagia, and onset of pneumonia during intervention were analyzed. The median duration from admission to the first swallowing round was 13 days (range 2-112 days). Stroke (17%) and pneumonia (14%) were common in our series. After the swallowing rounds, mechanical soft and thickened food was recommended in 26% of the patients, while paste food in 21%, mechanical soft food in 11%, and nothing by mouth in 11%. Thin liquid was suggested in 23%, honey thick in 16%, and no liquid is allowed in 4%. Eight patients (5.1%) developed pneumonia during hospitalization. Conclusion The swallowing rounds were effective to check the swallowing function and to decide the appropriate food and liquid. Dysphagia; Swallowing rounds; Videoendoscopic evaluation of swallowing Disclosure of interest The authors have not supplied their declaration of competing interest.

Canadian family physician Médecin de famille canadien, 2011

Japanese Journal of Comprehensive Rehabilitation Science

Objective: To retrospectively investigate the effect of ward rounds to check swallowing function (hereafter, swallowing rounds) on the outcome of dysphagic patients. Methods: Upon requests from ward nurses or clinical departments in our hospital, a full-time certified nurse specialist in dysphagia examines the general condition of patients and performs screening for dysphagia. For patients who require detailed investigations, a transdisciplinary dysphagia care team conducts ward rounds and evaluates these patients in principle by videoendoscopic evaluation of swallowing. We reviewed the records of patients in whom swallowing rounds were conducted between September 2006 and March 2010, and analyzed the food texture and eating status scale (ESS) scores at the first intervention, after the first intervention and at the last observation; dysphagia severity scale (DSS) scores at the first intervention and at the last observation; and onset of pneumonia during intervention. Results: Among 1,330 patients suspected of dysphagia, 998 were judged to require detailed investigations and swallowing rounds were conducted. As a result of intervention, significant improvements in food texture, ESS score, and DSS score were observed. The incidence of pneumonia was 3.7%. Discussion: Improvements in food texture, ESS score, and DSS score were achieved by conducting swallowing rounds.

Evidence-Based Laryngology

Background: Trouble in swallowing food is defined as dysphagia. There are many factors that predispose the person to swallowing issues such as neurological, muscular, anatomical, and psychological. This study is being conducted to see the effectiveness of the two therapeutic techniques: thermal stimulation and swallow maneuver. Through the finding of best therapeutic technique, therapist will be able to give better intervention to patients.

Otolaryngologic Clinics of North America, 2009

Dysphagia, or difficulty swallowing, occurs commonly, especially in elderly and debilitated patients. The exact prevalence of dysphagia is unknown, but some reports suggest that the prevalence could be as high as 22% in persons aged more than 50 years. 1 Approximately 10 million people are evaluated annually in the United States for swallowing difficulties. 2 Several studies conclude that between 300,000 and 600,000 individuals in the United States are affected by neurogenic causes of dysphagia each year. 3 Within the hospital setting, many persons experience dysphagia due to general weakness, debilitation, severe pulmonary disease, intubation, or a reduced level of alertness. These numbers clearly indicate a significant burden for treatment teams and patients alike.