Swallowing Disorders Evaluation

Your doctor or healthcare provider may have recommended that you be evaluated by a speech-language pathologist for a swallowing disorder, also called dysphagia.

Signs and Symptoms

• coughing while eating or right after
• wet or gurgly sounding voice during or after eating or drinking
• extra effort or time needed to chew or swallow
• food or liquid leaking from the mouth or getting stuck in the mouth
• recurring pneumonia or chest congestion after eating
• weight loss or dehydration from not being able to eat enough

If not properly treated, swallowing disorders can lead to:

• poor nutrition or dehydration
• risk of aspiration (food or liquid entering the airway), which can lead to pneumonia and chronic lung disease
• less enjoyment of eating or drinking
• embarrassment or isolation in social situations involving eating

Swallowing disorders may sometimes occur after treatment for head and neck cancers.

Evaluation

Your speech-language pathologist will:

1. Take a careful history of medical conditions and symptoms
2. Examine the strength and movement of the muscles involved in swallowing
3. Observe feeding to see posture, behavior, and oral movements during eating and drinking
4. Possibly perform special tests to evaluate swallowing, such as
   • modified barium swallow - the swallowing process is viewed on an X-ray as the food or liquid passes from the mouth through the pharynx and into the upper esophagus
   • endoscopic assessment -a lighted scope is inserted through the nose, and then the swallow can be viewed on a screen

Treatment

Treatment depends on the cause, symptoms, and type of swallowing problem.

Your speech-language pathologist may recommend:

• specific swallowing treatment (e.g., exercises to improve muscle movement)
• positions or strategies to help the individual swallow more effectively
• specific food and liquid textures that are easier and safer to swallow