Swallowing problems (Dysphagia)
Dysphagia, or difficulty in swallowing, can occur among people with MS. While more frequent in advanced disease, it can occur at any stage. The person may choke while drinking liquids, or eating certain foods, particularly those with crumbly textures.
When this happens, the food or liquids are inhaled into the trachea (windpipe) instead of going down the esophagus (gullet) and into the stomach. Once in the lungs, the inhaled food or liquids can cause pneumonia or abscesses. Because the food or drink is not reaching the stomach, a person may also be at risk for malnutrition or dehydration. Sometimes a person inhales small amounts of food or liquids without knowing it. This is called silent aspiration.
Diagnosing and Treating Dysphagia
Dysphagia is initially diagnosed by a careful history and neurologic examination of the tongue and swallowing muscles. Sometimes a special imaging procedure called a modified barium swallow is needed. In this test, the patient drinks or eats contrast material of different consistencies-thin liquid, thick liquid and solid. A videofluoroscope, which can trace the path of the contrast material, is used to film the swallowing. The precise location and manner of a swallowing defect can then be identified and treatment prescribed.
A speech therapist (or speech and language pathologist) is the professional who usually diagnoses and treats dysphagia. Treatment typically consists of changes in the diet, positioning of the head, exercises, or stimulation designed to improve swallowing. In very severe cases that do not respond to these measures, feeding tubes may be inserted directly into the stomach to provide the necessary fluids and nutrition.
Many people who have difficulty swallowing also have speech disorders. Speech therapists also evaluate, diagnose and treat these problems.
Source - The MS Information Sourcebook produced by the Information Resource Center and Library of the National Multiple Sclerosis Society. © 2001 The National Multiple Sclerosis Society. All rights reserved. Reproduced with permission.
