Do You Have A Swallowing Problem?
Many people these days know about the dangers of falling in the elderly. A fall can easily result in a hip fracture or head injury, a hospitalization, or even a fatality. But people may not realize that swallowing problems, too, account for tens of thousands of deaths annually in the United States. This brief article will tell you what to look out for so you can get proper evaluation and treatment for yourself or a loved one before a swallowing problem becomes life-threatening.
We swallow some 600 times per day. It’s not something we pay much attention to (if we pay attention at all) because it is so automatic. But as we age, we may pick up disorders such as Parkinson’s disease, congestive heart failure, lung disease, or Alzheimer’s that interfere with swallowing. It’s not just the elderly who are at risk. Younger persons with multiple sclerosis, head injury, or stroke are also vulnerable. To matters worse, sometimes the medicines used to treat these and other disorders complicate the picture. For example, antihistamines such as Benadryl (diphenhydramine) can reduce the supply of saliva and interfere with swallowing at several steps in the process.
Swallowing difficulties (also known as “dysphagia”) can cause death through (1) choking, (2) pneumonia, and (3) malnutrition. By choking we mean a major block of the airway (at the level of the throat or the windpipe), something that the Heimlich maneuver can keep from becoming fatal. Pneumonia typically results from breathing in (or “aspiration”) of food, liquid, or saliva that is loaded with bacteria from the mouth. Malnutrition weakens a person so they can not stand up to the challenges of infection or bounce back from cancer and its treatment.
These are questions to ask as they pertain to yourself or a loved one that may suggest a swallowing problem:
(1) Does food sometimes go down the wrong pipe?
(2) Does your voice sometimes sound “gurgly” or wet when you eat?
(3) Is eating sometimes less enjoyable than it used to be?
(4) Do you sometimes have trouble clearing food from your mouth in one swallow?
(5) Do you sometimes get the feeling that food is stuck in your throat?
(6) Have you had repeated pneumonia or other respiratory illnesses?
(7) Have you ever lost weight without trying?
(8) Do you often have trouble swallowing medications?
(9) Do you often choke or cough when you eat solid foods?
(10) Do you often have difficulty swallowing a specific food or liquid?
(11) Do tears come to your eyes when you eat?
(12) Does your nose run after you eat?
(13) Do you clear your throat a lot while eating?
(14) Does it take forever to get through a meal?
If you answered “Yes” to one or more of these questions, let your personal physician or other primary health care provider know. You may be referred to a swallowing specialist. This may be a speech-language pathologist. Such specialists have been trained in swallowing, which involves many of the same muscles and nerves that are involved in speaking.
Don’t wait to mention your questions and concerns to the doctor. These problems tend to persist and to get worse. So act before there’s a disaster.
To learn more about swallowing problems (dysphagia), visit the American Dysphagia Network at and read “Swallow Safely: How Swallowing Problems Threaten the Elderly and Others. A Caregiver’s Guide to Recognition, Treatment, and Prevention.” It is available through , (including a Kindle edition), and as an iBook.