Endoscopic video swallow research and swallowing disorders is the topic for today. If you think you may have dysphagia, there are certain symptoms that may be present along with difficulty swallowing. They include: drooling, a hoarse voice, feeling that something is lodged in the throat, regurgitation, unexpected weight loss, heartburn, coughing or choking when swallowing, pain when swallowing, difficulty chewing solid foods. These sensations may cause a person to avoid eating, skip meals, or lose their appetite. In severe cases, you may be admitted to the hospital and given food through a feeding tube. This special tube goes right into the stomach and bypasses the esophagus. Modified diets may also be necessary until the swallowing difficulty improves. This prevents dehydration and malnutrition.
Oral-motor treatments include stimulation to or actions of the lips, jaw, tongue, soft palate, pharynx, larynx, and respiratory muscles that are intended to influence the physiologic underpinnings of the oropharyngeal mechanism in order to improve its functions. Some of these interventions can also incorporate sensory stimulation. Oral-motor treatments range from passive to the more active (e.g., range-of-motion activities, resistance exercises, or chewing and swallowing exercises). Examples of exercises include the following: Laryngeal elevation —similar to the Mendelsohn maneuver (discussed in “Maneuvers” section above), the patient uses laryngeal elevation exercises to lift and maintain the larynx in an elevated position. The patient is asked to slide up a pitch scale and hold a high note for several seconds. This maintains the larynx in an elevated position. Masako or tongue hold —the patient holds the tongue forward between the teeth while swallowing; this is performed without food or liquid in the mouth, to prevent coughing or choking. Although sometimes referred to as the Masako “maneuver,” the Masako (tongue hold) is considered an exercise (not a maneuver), and its intent is to improve movement and strength of the posterior pharyngeal wall during the swallow. See additional details at Dysphagia in Motion.
These diets are all nutritionally adequate. However, some patients may have difficulty taking enough fluid and food to get all the energy and nutrients they need. In this case, an adjustment to diet or treatment will be required. Fluids are essential to maintain body functions. Usually 6 to 8 cups of liquid (48-64 oz) are needed daily. For some dysphagia patients, this may present problems because thin liquid can be more difficult to swallow. In this case, fluid can be thickened to make it easier to swallow. However, close monitoring by the dysphagia team is required for anyone drinking less than 4 cups of thickened fluid a day or anyone not progressing to thin liquids within 4 weeks. The greater problem for some patients is eating enough calories. The whole process of eating simply becomes too difficult and too tiring. However, calorie and protein intake can be increased by fortifying the foods the patient does eat.
We offer Flexible Endoscopic Evaluation of Swallowing (FEES), a gold-standard, evidence-based procedure that can be performed at the patient’s bedside with no barium consumption or radiation exposure. Using the flexible endoscope, we’re able to visualize the swallow in a patient’s natural eating environment to assess swallowing function. FEES is a cost-effective alternative to Modified Barium Swallow Studies (MBSS) at 1/4 of the price with no transportation or mileage costs to your facility. Discover more details at https://www.dysphagiainmotion.com/.