Swallowing Disorders and Treatment Options
Вставка
- Опубліковано 3 чер 2024
- Speech pathologist Tiffany Turner explains how swallowing works, what causes dysphagia, and how dysphagia can be treated. For more information and free resources, visit SNR's website at www.owassosnr.com.
Thank you for the information in your video. I've been looking for information and watching videos. Yours is one of the very best I have seen as it fills in some gaps for me. I choke swallowing water. Putting my head forward helps but what I need is a good doctor which I've not been able to find.
Tiffany, this is a fantastic video. Thank you for sharing. I am a SLP student and this clarifies my theory studies.
Thank you for your explanation of swallowing dynamics.
Always heard a treatment that doctors recommend is adding thickening powder to food and water to prevent aspiration from happening.
Thank you.. glad I could find this... having a bit of trouble lately...
Excellent video and explanation of the swallow Tiffany!
Thanks Jena! :)
I appreciate your explanation for swallow studies. Thanks!
Thanks for the kind words! I'm glad you've found it to be useful. If you're a student, check out our website at www.tulsasnr.com for more resources. :)
+Swallowing and Neurological Rehabilitation, LLC This happens to kids too, right? Because I'm only 11 and I'm experiencing this. Whenever I eat I bring a glass of water because without it the food gets stuck in my throat. Should I go see a doctor, or wait until is goes away?? Pls answer
Thank you for your video..excelent explanation
Love the information!
Hi Tiffany, Thank you for the video.
I have a 3 Yrs old Daughter with Kabuki Syndrome. She used to be on NG tube for 2 yrs then she changed to G tube after gastrostomy.
She started to drink water very well and without aspiration and never had anything returned to lungs. She also started to eat thicker stuff like flavored yogurt. She set on table during meals and tries to eat but she usually keeps food on the front teeth then keep on chowing for long time before she surrender or get bored and take it off her mouth.
I cant see any organic problem but I dont know why she refuse to swallow boluses. what is your view to this and your suggestion knowing that I am living outside the US.
Thanks again
Do you know of any such treatments for the lower esphogeal muscle which is Achalasia?
Swallowing, sometimes called deglutition in scientific contexts, is the process in the human or animal body that makes something pass from the mouth, to the pharynx, and into the esophagus, while shutting the epiglottis. Swallowing is an important part of eating and drinking. If the process fails and the material (such as food, drink, or medicine) goes through the trachea, then choking or pulmonary aspiration can occur. In the human body the automatic temporary closing of the epiglottis is controlled by the swallowing reflex.
Involuntary process follows soon after sensors at back of tongue detects food as bolus :
There are sensors at the back of tongue 😜 that are able to primarily detects any food solid or fluid as food bolus but during weakness illness or neurological certain deficit during such as stroke paralysis or similar conditions, evidentiary sensors at the back of tongue fails to detect the especially fluid as food bolus and thus then sensors fails to send message to brain to move epiglottis valve to shut the wind pipe and jeep food pipe open
So incidentally that fluid or food takes its free flow in lung instead of food pipe.
[ bacteria settles there in Lung, mostly in almost all older adults ( MYTHS OF feeding Jay on bed and feeding fluids more endangering risk of chest infection at ease and that is mostly fatal accepted accident as natural by people not knowing these all how sad!!)
HENCE ITS ISIMPIRTANT TO FIND A POWDER FOOD THICKENER TO CREATE A BOLUS LIJE DAHI OR CURD OR YOGURT CONSISTENCY allowing ability of sensors at back of tongue to detect foodliquid as bolus and send instant message to brain to move epiglottis to cover wind pipe and leave food pipe open.
This process can also be disturbed distracted eating time we call that as choking, while food piece sits on top of epiglottis and a thump between scapula fix the issue, nor may coughing is encourages as first aid, leave coughing undisturbed
Thumping is only attempted in ABSENCE OF COUGHING ABILITY
The portion of food, drink, or other material that will move through the neck in one swallow is called a bolus.
Hi Tiffany. I'm an MSc Audiology and Speech Disorders student. Your videos are so informing and I really enjoy them. I want to ask you about Ampcare which is also a NMES device that I just heard of. There are a few researches about it but want to take your opinion as well. Do you have any idea about it's efficacy?
Thanks doctor I alsoo have that problem
Hi, I have a motility issue my esophageal muscles are working at 50%. i did an upper endoscopy, barium swallow, and motility test (tube up nose) and this was the only feed back i got. It's tough getting food down, there's a lot of pressure I try and hydrate when eating. I get the acid reflux flare up at night. I'm nervous about taking reglan due to side effects even at 5mg a day but someone i know abroad was able to get me domperidome and will start that 4x a day at 10mg. I'm not even 30 I don't know how this happened. I try and stay away from dry foods along with acid reflux triggers but doesnt help much. I'm trying breathing exercises to strengthen the muscles but no change yet. Help anyone? Been suffering for months!
hello...
i have this problem for almost an year, while i eating anything specially hard foods and dry foods..sometimes i feel like breathing difficulty too...i am taking GERD medicines like the last two months...always have chest burning problem and bowel problems...so nowadays i m usd to eat only soft foods than the hard type foods...hope i will get a good advice about the excercise that can help me out to avoid this problem...GERD is horrible..
Thanks so much for this video! Your starter kit has been great as well! Where did you get that wonderful visual?? I use a handout that I have blown up as much as possible but it' snot as pretty as yours :-)
Leeta White I'm glad our resources have been helpful to you! :-) I don't know where I got the images, but the brand is Body Part Charts.
Thank you for sharing :)
Hello please respond to me if you could. My daughter was born 1pound 6 ounces and had pretty bad reflux and and when she got big enough to drink and que she got exhausted quickly when trying suck from the bottle. With no improvement I made the decision to have a Gtube placed in order to bring her home. Bottle feedings did not get better and we were advised to discontinue bottle feedings all together and practice with the spoon and watered down puree which was a fail. Her reflux has reduced by 90% she is now 1year old adjusted age and is willing to "taste" everything ON HER OWN. If you try to feed her she rejects it all together, but if she just grabs and kind of steals our food from off our plates she will bite and chew but will not swallow the food. It ends up tucked between her teeth and lips completely chewed up and ready to be swallowed.
I need more advice does this seem like swallowing disorder? Should she be tested? What can I do at home to help or show her how to swallow? Her Gtube cord terrifies me no matter how I secure it I fear her rolling herself up in this tubing and being strangled to the point where I don't sleep and when I do I. constantly jumping out of my sleep. I say these things at every appointment but it's like "ooook so let's talk about something else" never "I hear your concerns and this is what you should do or try". I've asked for a barium swallow multiple times and been told that she doesn't need one. I'm in Philadelphia and she goes to Children's Hospital they say they ARE the best but I'm not so certain that is true for each individual specialist it seems like a broad statement to make.
Hello, I am recovering from a Myastenia Gravis Crisis My swallowing hasn't come back yet... I am getting feed from a PEG Tube...What can i do to help me swallow?
One doc told me that speech therapy will not help with my problem, he gave me pills that did not work, so he recommended surgery. It helps if I lean my head forward and turn my head to the left then swallow. Sometimes a pill will get stuck in the back of my throat somehow.
Truth Finder Please see a physician (ENT and/or neurologist) and speech pathologist in your area specifically specializing in swallowing disorders. All swallowing problems are different, and this is a very specific niche, so seeing someone specialized in this area is very important. The treatment depends on the nature of the condition, whether it's progressive, etc.
I have multiple sclerosis and have swallowing problems. It's very scarey sometimes
what shampoo are u using ?
Almost 2 years ago i was eating nerds and i felt like one didnt go down and like it got stuck i tried throwing up but nothing would come out the feeling was still there, ever since that day i feel pain on the sides of my neck/throat i cant swallow right, it hurts when i swallow. Ive done every test and no one is helping me. I feel like im slowly dying and no one is willing to save me. I feel pain everyday im suffering so much and no one can help me
Research some hospital that treat dysphagia
so understand you((
Hi Tiffany, my husband has had tonsil concer and is now suffering from dysphagia and is on the feeding tube. He has severe fibrosis and stiff neck. Docs say there is no treatment for him except exercise. Are there any treatments to help him?
Jasmina Wadhwani - hi, I'm sorry to hear that about your husband, but hopefully he is on the way to recovery! I would strongly encourage him to pursue treatment to break up the scar tissue. This can be done by a speech pathologist who is specially trained in a technique (such as Myofascial Release) or a physical therapist who is specially trained (using something like ASTYM on the front of the neck area).
The whole swallowing mechanism moves up and forward when we swallow, but if there is too much scar tissue around the structures, they can't move. It's like there are rocks packed around the structures so to speak. The treatment approach we take in these cases is to first address the fibrosis by using one of the above methods to break up scar tissue. Once the "rocks" are broken up and the structures "can" move, then aggressive swallowing exercises are needed to get the internal swallowing structures moving well again. They often become very weak from not moving fully for a period of time due to the fibrosis.
It's very important that he has a swallow study to determine which specific exercises or programs would be best for him and what foods and liquids are best for him to swallow. Depending on the severity, there are different programs that could be beneficial (McNeill Dysphagia Therapy Program if very severe and he's been on a limited diet for a period of time, neuromuscular electrical stimulation possibly once enough scar tissue was broken up so that the muscles could even be reached, etc.). I would encourage you to locate a swallowing specialist near you. You can search here by location: www.swallowingdisorders.org/search/custom.asp?id=1177
If that link doesn't bring up any board certified swallowing specialists near you, I'd look here and just call and specifically ask about training and experience with treating fibrosis-related dysphagia in post head and neck cancer patients and what approaches they use. Link: find.asha.org:8085/pro#f:@Provider=[Speech-Language%20Pathologist]
This is an area we work with frequently at our center and are very passionate about. Please do research to find someone with experience in this specific niche. Internal exercises alone won't help if scar tissue is taking over and the structures can't move. Best of luck to you and your husband. I hope he is able to make some good progress!
Swallowing and Neurological Rehabilitation, LLC
Hi Tiffany, thx for your quick response and thorough explanation.
I forgot to mention I'm enquiring from Hong Kong. Also, Perhaps his condition is different as the fibrosis that is causing stiffness of his neck is external as several endoscopies have shown that the inside is not narrow however coz of radiation the epiglottis is demaged therefore causing the food to go into his lungs and not stomach.
We have researched and found several ways that can help such as ultrasound therapy, acupunture, electosis, etc but Docs refuse to use any of these on him in the fear to triger the cancer cells and cause a relapse.
Jasmina Wadhwani Fibrosis isn't "visible" on the inside on endoscopy per say. It makes structures stiff (the epiglottis cartilage is one that commonly becomes stiff and immobile due to radiation). It wouldn't actually LOOK narrow or different on a swallow study or scope; you would just see a general lack of movement of those structures ("frozen larynx" is how scar tissue presents internally since it's invisible otherwise) . If the front of the neck is stiff, it is highly likely those internal structures just underneath that are too. Are therapy services available there? I would definitely look into the fibrosis treatment and swallowing exercises. It's definitely the least risky option to trial at first before attempting anything more invasive. Esophageal dilations are also often common post radiation, as the UES (opening to the esophagus) can also sometimes become immobile from scar tissue too, making it difficult for things to pass through into the esophagus. It's usually combination of several factors that all need to be addressed. But if he's not had any treatment for the fibrosis in the neck, that's definitely something to pursue from an SLP or PT if you can locate one in your area. I hope he gets the help needs and makes the best possible recovery. :)
My mother started to have occasion dysphasia after a Broncoscopy. Could something could have been damaged from the broncoscopy?
Jeff Akira I had an endoscopy and my problems started after. Doctor does believe it had something to do with it.
Anything being passed through the larynx can affect the voice and swallowing musculature. The structures themselves could be damaged, or there could be nerve damage. Definitely obtain imaging from an ENT and a swallow study to see if there is any damage or weakness to explain your symptoms and identify appropriate treatment options.
@@swallowingandneurologicalrehab is it difficult to Sing with Globus Pharyngeus Syndrome?
I have had difficulties in swallowing for around 10 years now, and although I rarely getaspiration, or food and drink going down the airway. I do find that my mouth and throatare nearly always dry, causing often great difficulty in getting food down my gullet.I tend to eat only soft foods because of this, such as very soft wheat cereal for breakfast, and then for other meals mashed potatoes, scrambled eggs and soft mashedvegetables. This condition causes me a great deal of anxiety when I face having to eata meal. For some time, I have been having an alcoholic drink before a meal to ease theanxiety, but I know this will only lead to further problems in the future. I am by nature ananxious person, and as a child choked on a small pill. So I tend to crush tablets now,and have noticed that certain pills aggravate my swallowing problem. Could this be thecause of my eating disorder now. I am in my late 50's.
Hi Gary, it sounds like you certainly need a swallowing evaluation to determine the type and severity of your dysphagia and for development of a treatment plan or strategies. I would suggest discussing your issues with your physician first and foremost and asking them if they can refer you to a speech pathologist in your area who specializes in swallowing. You may need evaluations by other specialties too, such as an ear, nose, and throat doctor and/or a GI doctor. Here is a link to the American Speech-Language Hearing Association's Find a Professional tool where you can search by zip code for speech pathologists who treat swallowing. Best of luck with your treatment.
find.asha.org:8085/pro
+Swallowing and Neurological Rehabilitation, LLC Hi, Ms Turner, and I thank you for your advice. I have had a long term problem withAnxiety. So, the thought of visiting my GP (GP) known here in the UK as a Doctor of General Practise has always frightened me. Thisis because I have heard so many Horror stories of people having atube pushed down the throat, for a thorough examination of theGullet and just what is going on. I once choked on a very small pillas a child, and have always crushed pills ever since. Do you thinkthis could be part of my problem in swallowing? I have noticed thatcertain pills certainly make it worse. PS. Remember what happenedto Joan Rivers when she had a narrowing of the Trachea and whathappened to her when she went in for a routine diagnosis.
Gary Dunn
where are you. I need your help bad. I have esophagitis. And every time I eat. I think about what if, Death. yes death. this video really help. I'm going to get the surgery soon. I think it's both pitcher and catcher.
I have a hard time to swallow my food. and no one listens to me. I need help would you be able to help?
Hi Ashley, contact the clinic at 918-928-4700, and we'd be happy to discuss treatment options with you. If you're not in the OK area, I would suggest visiting the ASHA site here (www.asha.org/profind/) to find a certified speech pathologist near you who specializes in swallowing.
Try Schatzki's Ring
Great non extremely complicated video. #anslpmyself
Is fear also a common cause of swallowing problems? Situation: I am 29 years old, healthy, but 1 year ago I suffocated eating cookies (they were very dry, and had mount dry in that moment, so when swallowing it got stuck in the throat, could not breath for like 30 seconds - or more not sure - it seemed like forever because I tought I would die and was alone at home - luckily did not died because could force the food down, but was a close visit from the grim reaper). It scared me so much, that I could not eat well for 1 week, had fear of swalloing, it seamed that my throat was to small and had fear food could get stuck again . Because I eated very little after that, and got very anxious, 1 week after I got potassium deficiency (Hypokalemia) and had to go to hospital because of irregular heart beat. There I talked about my throat problem, and a otolaryngologist used a tube from my nose to my vocal chords, to see I had anything strange in throat, but said it was ok, nothing obstructing it. My difficultie swallowing food keep till today, a year later. But swallowing water from a glass/bottle I don't have any problem or fear, it is normal. So I created a "technique" so I could eat: before swallowing, with food in mouth, I drink a little water and dilute everything almost like gargle, mixing food with water, then try to aspire that very quickly, but I take a lot of time trying to get courage to do it. Sometimes in the process I cough because food get half stuck, but I think it his because I am to tense and forgot how to swallow. I eat almost like taking pills with water. Strangely, water from soup I can't swallow, I need this water thecnique. The only thing I can eat more or less without wter is hard apples (but if I tink to much about it I can't sometimes). This gave me a lot of problems, since I drink a lot of water in each meal, and because of that I wake up every night 2 times to go wc urinate, and since I am anxious because of this I have insomnias , and am sleeping very very little because of this (6 to 3 hours night); and with people around it is a lot harder swallowing, because I am afraid people see me suffocationg, or do my crazy "techniques" trying to swallow like a crazy man, and I get to tense, so I dont eat in restaurants or go out with people for a year because of this.
I live in Portugal, and never heard of swallowing treatments, the doctors I went to in the public health system, never helped me, neither did great exams (only the exame with a tube down the nose to see inside throat to the vocal chords) and thyroid exam, but all seamed ok), and ended up saying it must be psychological and that it will go away with time. But a year has went by already... And no change. My question is: is this common and noraml? Fear can make this problem? Or it could have a phisical cause also since my throat seems weak and I asfixiat frequently since this incident (my theory is that I heasitate a lot swallowing and that is the cause, but not sure)? Sorry to bother and thank you for sharing this info.
+Paulo Martins It sounds psychological. If it is psychological, that could be helped by A) a psychologist, or B) a speech language pathologist (specifically a swallowing specialist).
Hello! I'm 22 years old female from Morocco. Reading your comment has brought tears to my eyes because I'm suffering from the exact same thing. Last June, I was eating chicken and I accidentally swallowed a small piece of preserved lemon. I freaked out and drunk plenty of water. I was able to talk but I was completely terrified then I threw up. After that I felt that something was in my throat so the next day I saw an ENT he looked at my throat but without a tube. He said that I had an inflammation and gave me an anti inflammatory medication. A week later the lump in my throat has disappeared. I started eating again but I was chewing over over and over and I was pretty conscious about my swallowing. I looked online and I have discovered that I'm suffering from something called choking phobia and I had a choking incident when I was 7 and I still can't forget it so the last year's incident has reminded me of it. After that the lump in my throat kept coming and going and I started to avoid solid food. I'm surviving on soups, mashed potatoes, yogurt , ice cream and cheese. I recently saw a cardiologist because my heart starts beating fast from time to time. I did a blood test for goiter and anemia but they were fine. This is driving me crazy I constantly feel that there's something in my throat I have forgotten how to swallow solid food . I once tried to challenge myself and a pizza with a friend a small one and it took me more than two hours to finish it. I'm suffering from sever anxiety and I've had many panic attacks when I see food and I lost 7 kg. I also crush the pills and afraid to swallow them and this video scared me a lot. :( here in Morocco physiological health isn't given an importance and I feel lost completely lost and depressed. is there way to keep in touch with you :( ?
Fati Flower are you still having this problem?
i am suffering the same problem as i have gotten food stuck in my throat three times now! it is making it hard and scary to swallow! i am even now starting to struggle with even mash potato 😢 i wish I could find a cure, because i am majorly chronically ill already and if i don't eat enough i end up more ill!
Good Wilfredo Hundana a as I was not expected to "Live beyond " teen. And am proving Vodaphine wrong that I was meant to be online!
I am having a swallowing problem now for 3 months and they tell me that this is my mind.Can i get help please!!!!
Truth in the USA - Please locate a speech pathologist near you who specializes in swallowing. An individual assessment is crucial since no two swallowing problems are the same. I would also strongly encourage a medical/neurological workup for any new gradual onset of swallowing symptoms if the cause is unknown. I hope you get the help you need. Best of luck! find.asha.org:8085/pro#f:@Provider=[Speech-Language%20Pathologist]
I was told I have dysphagia and it turned out to be something with my thyroid.
Do you mind telling me what was wrong with your thyroid? My mom is struggling.
@@bethanymorgan6930 5 nodules found after ultrasound. 1 very large 5 cm. The rest are also big but after biopsy all benign but the 5 cm biopsy cannot be trusted as it is too big to get an accurate biopsy so they said either take it out or watch it for a while. Surprisingly my thyroid count on my blood work was normal. Also, one of the smaller nodules is up against my esophagus and it makes me feel full all the time. If your mom's blood work is off she may need a simple pill.
@@marymarth7298 thank You so Much for sharing this.. the ENT said her thyroid was atrophied. Her labs seem ok.. I’m praying for answers. She can’t talk hardly and a lot of trouble swallowing. 🙏🙏🙏
@@bethanymorgan6930 You are welcome. She may have to have her thyroid taken out or half of it then take a thyroid replacement pill. Things happen that we don't have any control over. Most important thing is to tell your doctor of any new findings even small lumps/bumps so they can be checked as soon as possible and taken care of. Hope and pray your mother is ok. I had to go to an ear, nose and throat doctor to do some tests after the ultrasound findings showed the nodules then I had to have a biopsy of each one of the 5 nodules. Everything I went through was tolerable.
What about MS??
I'm having trouble with food coming back into the nasal passages instead of going down.
LissaSun - Please locate a speech pathologist specializing in swallowing near you. If this is a new issue with no known medical diagnosis, a medical/neurological assessment is the first step to determine the cause. find.asha.org:8085/pro#f:@Provider=[Speech-Language%20Pathologist]
liquid thickener thickens fluid to yogurt consistency to allow sensors detect fluid as food bolus, thickening lasts only 60 seconds thereafter it's turns to fluid state during peristalsis and thickening powder dies not change colour taste nutritive values
Swallowing, sometimes called deglutition in scientific contexts, is the process in the human or animal body that makes something pass from the mouth, to the pharynx, and into the esophagus, while shutting the epiglottis. Swallowing is an important part of eating and drinking. If the process fails and the material (such as food, drink, or medicine) goes through the trachea, then choking or pulmonary aspiration can occur. In the human body the automatic temporary closing of the epiglottis is controlled by the swallowing reflex.
Involuntary process follows soon after sensors at back of tongue detects food as bolus :
There are sensors at the back of tongue 😜 that are able to primarily detects any food solid or fluid as food bolus but during weakness illness or neurological certain deficit during such as stroke paralysis or similar conditions, evidentiary sensors at the back of tongue fails to detect the especially fluid as food bolus and thus then sensors fails to send message to brain to move epiglottis valve to shut the wind pipe and jeep food pipe open
So incidentally that fluid or food takes its free flow in lung instead of food pipe.
[ bacteria settles there in Lung, mostly in almost all older adults ( MYTHS OF feeding Jay on bed and feeding fluids more endangering risk of chest infection at ease and that is mostly fatal accepted accident as natural by people not knowing these all how sad!!)
HENCE ITS ISIMPIRTANT TO FIND A POWDER FOOD THICKENER TO CREATE A BOLUS LIJE DAHI OR CURD OR YOGURT CONSISTENCY allowing ability of sensors at back of tongue to detect foodliquid as bolus and send instant message to brain to move epiglottis to cover wind pipe and leave food pipe open.
This process can also be disturbed distracted eating time we call that as choking, while food piece sits on top of epiglottis and a thump between scapula fix the issue, nor may coughing is encourages as first aid, leave coughing undisturbed
Thumping is only attempted in ABSENCE OF COUGHING ABILITY
The portion of food, drink, or other material that will move through the neck in one swallow is called a bolus.
My father just got off intibation, and he is dying to eat or drink. Because he's older and has a bleeding problem right now...they don't want to put a feeding tube in. He failed both thin and thick liquid swallowing tests, and he is begging for food and drink. They will try again in the morning. Don't really know what to do...feeling helpless. I just don't want him to leave this world thirsty and hungry. It never occurred to me that he would have trouble swallowing...I thought the danger was breathing.
Edmund Janas I hope your dad is okay and was able to eat and drink.
I'm so sorry :(
Hi I'm from India and I'm also having swalloing disorder . It has been 3 years . I can't eat solid food ... When I chew I get tired very quickly and my upper shoulder and part below the brain tend to get cramped feeling .. I eat only liquid food .. mixing in grinder and swallowing it . I went for check up CT , MRI but they said it was normal . Please help .. my health has degraded . I think I have forgotten how to eat normally ..
Am telling YOU, I was met to Be in the dimension aaaaaaan!
Maaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaawaaaaaaaaaan.
my breathing stops during chewing and swallowing . Takes forever cant suck through straws or drink liquids to thick aswell certain foods or more difficult like firmer ones or ore textures that dont clear easily with one swallow . i gasp for air after each swallow. Also make funny faces during swallowing.
cant see
Can botic cause it
Do you mean antibiotics? And how is your swallowing now btw?
I have a hard time to swallow my food. and no one listens to me. I need help would you be able to help?
+Ashley Greenlee I would suggest visiting the ASHA site here (www.asha.org/profind/) to find a certified speech pathologist near you who specializes in swallowing. Your physician should evaluate you first and make a speech pathology referral thereafter to assess swallowing and determine the best treatment options.
Ashley Greenlee me too but it's sticky phlegm that gets stuck with the food and sometimes comes back up my mouth
Anwar Ali What's that
Is there a Homeopathic meds in the phils?
I have that problem I can’t even swollen my food right I always choke and feel low there’s food stuck in my throat all the time I eat soup becuse it goes down easy and no one believes me and i get so upset and angry no one understands me I have anixiety disorder