Dysphagia: current reality and scope of the problem

Abstract

Dysphagia is a symptom of swallowing dysfunction that occurs between the mouth and the stomach. Although oropharyngeal dysphagia is a highly prevalent condition (occurring in up to 50% of elderly people and 50% of patients with neurological conditions) and is associated with aspiration, severe nutritional and respiratory complications and even death, most patients are not diagnosed and do not receive any treatment. By contrast, oesophageal dysphagia is less prevalent and less severe, but with better recognized symptoms caused by diseases affecting the enteric nervous system and/or oesophageal muscular layers. Recognition of the clinical relevance and complications of oesophageal and oropharyngeal dysphagia is growing among health-care professionals in many fields. In addition, the emergence of new methods to screen and assess swallow function at both the oropharynx and oesophagus, and marked advances in understanding the pathophysiology of these conditions, is paving the way for a new era of intensive research and active therapeutic strategies for affected patients. Indeed, a unified field of deglutology is developing, with new professional profiles to cover the needs of all patients with dysphagia in a nonfragmented way.

Effects of Capsaicin on Older Patients with Oropharyngeal Dysphagia: A Double-Blind, Placebo-Controlled, Crossover Study

“…There are many factors involved in the pathophysiology of OD. While most diseases leading to OD are increasingly prevalent with advancing age, the physiological changes of aging are also linked to the risk of OD [11,12,13]. Loss of muscle thickness and function, a reduction in tissue elasticity, changes in the cervical spine, reduction of saliva production, impaired dental status, reduced oral and pharyngeal sensitivity, reduced olfactory and gustatory function, and reduced compensatory capacity of the aging brain increase the susceptibility to OD and may act as precipitating factors [14].…”

Kinematic Visual Biofeedback Improves Accuracy of Learning a Swallowing Maneuver and Accuracy of Clinician Cues During Training

“…The three visual biofeedback protocols included: (1) ssEMG biofeedback (N= 10), VF biofeedback (N=12), and Mixed biofeedback (N=13). In the ssEMG biofeedback group, submental surface EMG was used for visual biofeedback during both the first accurate demonstration and the training.…”

“…Oropharyngeal dysphagia is a highly prevalent, yet under diagnosed condition, affecting the elderly population, patients with neurological or neurodegenerative disorders and those with head and neck diseases (1). Dysphagia management is designed to target the specific pathophysiologic processes responsible for the impairment, including training swallowing novel maneuvers.…”

Identification of Swallowing Tasks From a Modified Barium Swallow Study That Optimize the Detection of Physiological Impairment

“…Because standardized health care practices, including diagnostic procedures and interventions, have been shown to optimize patient safety and outcomes, attempts have been made to standardize the MBSS to facilitate transparency in data acquisition and reproducibility of diagnostic information across clinics and laboratories (Agency for Healthcare Research and Quality, 2003;Ciucci, Jones, Malandraki, & Hutcheson, 2016;Clave & Shaker, 2015). Doing so has allowed for the consistent identification of physiological impairment(s) and the development of treatment plans known to effect positive change in swallowing physiology (Jaffer, Ng, Au, & Steele, 2015;Logemann, 1987;Martin-Harris et al, 2008;Palmer, Kuhlemeier, Tippett, & Lynch, 1993).…”