Swallowing is one of the body’s most important functions. It is the way in which food reaches the stomach, allowing the body to absorb important nutrients. When swallowing becomes impaired, eating and drinking can become difficult and health can suffer, potentially resulting in dehydration and malnutrition.
Unfortunately, swallowing difficulties (dysphagia) can occur commonly in the elderly; it’s estimated that one-quarter may develop a swallowing difficulty at some point. Studies are underway to figure out how to avoid swallowing difficulties in seniors, protect this important bodily function and avoid potentially fatal consequences.
Swallowing is actually a 3-step process:
- The tongue moves up and back against the hard palate. Food is lubricated by saliva.
- Food passes into the esophagus to avoid the respiratory tract.
- The esophagus contracts and relaxes to move food into the stomach.
There are many complex physiological actions that take place within each one of these steps. At any point, food may not move in the right direction through the mouth and toward the esophagus. It may not be completely softened by saliva, or it may not move into the stomach properly. For example, if food does not move into the esophagus properly to begin its journey to the stomach it can move:
- Back into the mouth
- Up into the nose
- Forward and down into the larynx and the respiratory tract
Those issues all put seniors at higher risk for getting food into their lungs, which increases the risks of aspiration pneumonia which can lead to death.
A team of researchers at Johns Hopkins hopes to discover how rehabilitation experts can prevent problems in seniors at risk for swallowing disorders. They conducted a study of two groups of adults with no swallowing problems:
- 31 adults between the ages of 62 and 91
- 33 adults between the ages of 18 and 28
Each group underwent x-ray testing to determine the function of their swallowing process; how long their windpipe was closed off during a swallow, how long it took to close the windpipe- an airway, and how food was prevented in getting into the lungs.
The study found “In the older adults, the swallow started later. This meant the food was getting to the throat later, and it took longer for the start of actions to prevent food from getting into the airway.”
Symptoms of dysphagia
People who have acid reflux, or GERD (gastroesophageal reflux disease), may have trouble swallowing as well. It may begin to occur slowly and then become more frequent. Symptoms of dysphagia can include:
- Pain when swallowing
- Sore throat
- Choking and coughing
- Gurgling or regurgitating food or stomach acids
- Feeling that food is stuck behind your breastbone
- Burning sensation behind the breastbone (heartburn)
How is dysphagia diagnosed?
If a senior is having swallowing difficulties, he or she should visit his or her primary care physician who will do a physical exam, and look into the mouth and throat. There are several diagnostic tests that may also be ordered. They can include:
- A barium X-ray that checks the inside of the esophagus for blockages or any physical abnormalities.
- A gastroenterologist may perform an endoscopy, in which a tiny tube with a camera on the end is inserted into the esophagus. It gives the doctor a detailed view of the esophagus.
- Manometry may also be performed. It checks the pressure of the muscles in the throat during swallowing.
How is dysphagia treated?
Once clinical examinations and tests have been conducted, a speech-language pathologist will perform a swallowing evaluation to diagnosis dysphagia. When the evaluation has been completed and a diagnosis reached, the pathologist may recommend one or several of the following steps to treat the disorder:
- Diet modification
- Swallowing exercises to strengthen muscles
- Swallowing strategies to compensate for the difficulties
- Modifications to posture that may help swallowing while eating
If you notice that your loved one is having problems swallowing, inform their primary care physician. It’s important that they be checked for swallowing difficulties before it becomes a serious problem. Getting early treatment will help to avoid malnutrition and dehydration.
If you or your family member is considering in-home care as part of a plan to age in place, contact Family Matters In-Home Care today for a free consultation. Our team is dedicated to supporting your family and helping older adults enjoy life in the comfort of their own home for as long as possible.
Some of the services offered by Family Matter In-Home Care include: Alzheimer’s & Dementia Care, Bed & Wheelchair Transfer Assistance, Companionship, Housekeeping & Meal Preparation, Personal Care, Recovery Care, and Transportation.