While many people think of communication disorders when they think of speech-language pathologists, these medical professionals also help patients with trouble swallowing.
Swallowing disorders, or “dysphagia,” can include pain, the feeling that something is stuck in the throat, or losing the ability to swallow altogether.
Speech-language pathologists can help patients stay safe and return to as normal a diet as possible.
Speech-language pathologists are best known for helping patients overcome communication disorders. But they can also provide therapy for another issue related to the muscles of the throat and mouth – dysphagia, or swallowing disorders.
Dianne Hightower, M.A., CCC-SLP and Michelle Fowke, CCC-SLP are speech-language pathologists at Regional One Health. Hightower sees patients at our Outpatient Rehabilitation Center downtown and Fowke is located at our East Campus Center for Rehabilitative Medicine.
They said dysphagia can disrupt a patient’s daily life and put them at risk of aspiration, poor nutrition and pneumonia, so proper treatment is important. “Our goal is to get our patients to the least restrictive diet that is safe,” Hightower said.
There are many conditions that can cause dysphagia: brain injury, neurological conditions like ALS or Parkinson’s disease, stroke, and head and neck cancer are some of the most common.
Some patients are referred to a speech-language pathologist from an acute care setting, often with a feeding tube. In these cases, the patient has usually suffered a stroke, traumatic injury or illness, and the speech-language pathologist is part of their overall rehabilitation team.
Other patients, however, notice symptoms on their own. Fowke said signs of dysphagia include inability to swallow, pain while swallowing, or feeling like something is stuck in your throat.
Patients might notice they are coughing or clearing their throat while eating or drinking: “You might have a gurgle in your voice,” Hightower said. “That could indicate liquid is sitting on your vocal cords, which are at the entrance of the airway.”
The first step is getting an accurate diagnosis.
Speech-language pathologists work with the rest of the patient’s medical team to understand the cause of the dysphagia, and the Outpatient Rehabilitation Center at the downtown campus offers a test called a modified barium swallow.
During the test, Hightower said, speech-language pathologists work with radiologists to review X-ray images of a patient swallowing various consistencies. The images tell them whether the patient is aspirating and where the patient is having weakness or delays so they can determine proper treatment.
Speech-language pathologists have several tools at their disposal to help.
Specialized exercises are one option. While many of us take the process of swallowing for granted, it is actually quite complex, involving the brain, esophagus and multiple muscles, nerves and muscular valves. By strengthening the oral and pharyngeal muscles and training them to work together properly, speech-language pathologists can make lasting improvements for their patients.
Hightower said another option is VitalStim, a medical device that applies electrodes to the neck area to deliver electrical impulses to the muscles. “This can increase strength and improve the impact of the exercises the patient is doing,” she said.
While many patients see significant improvement, severe dysphagia might not be fully resolved through strengthening. “We can also teach patients compensatory strategies to improve safety,” Fowke said. “These might include specific techniques or diet texture modifications.”
It’s important for patients to seek help for dysphagia, as it can cause serious problems. “One of the biggest concerns is aspiration, when liquid or food enters the airway while swallowing,” Hightower said. “That can potentially develop into aspiration pneumonia.”
Patients can also suffer from poor nutrition or dehydration if they avoid certain foods or limit eating and drinking altogether. This can lead to weight loss, weakness and overall poor health.
“By addressing swallowing issues right away, we can make sure these things don’t happen,” said Hightower.
“We can help patients find the safest food texture or liquid consistency and develop a treatment program to help them get better and get back to a more normal diet.”