By Virginia Stewart
“Think of the one food you love to have when you go out for a celebration dinner. Now, think that you might never have that again,” says Phil Hartzler, a 69 year old retired banker who suffered from a swallowing disorder that left him unable to drink or eat for five months after a stroke.
According to the American Speech Language Hearing Association, one in 25 people will experience dysphagia in their lifetime. Dysphagia is the medical term for difficulty swallowing and can be caused by a number of issues. “People from across the entire lifespan can suffer from dysphagia – infants who are premature to children who have anatomical issues like cleft to adults who have suffered a stroke or have a disease like Parkinson’s or Alzheimer’s,” says Pamela Smith, PhD, a professor of Speech Pathology at Bloomsburg University in Pennsylvania.
Patients who suffer from dysphagia are at risk for a number of factors, including dehydration, aspiration and mental health issues like depression. “Patients who cannot drink sufficient liquids are at risk of becoming dehydrated for sure,” Smith says. Patients are often given thickening liquids but severely dislike the taste of them. “Patients tend to hate thickening liquids so I make all of my students try thickener, to understand the aversion. Thickeners change the taste and the mouth feel and the liquids don’t feel normal. Many patients prefer to use a small sips cup, like the Provale Cup, that delivers a fixed amount of liquid.” The Provale Cup helps avoid the use of thickened liquids by regulating the volume being swallowed at one time, so people aren’t impulsively chugging.
Feeding tubes are also used to treat the malnutrition and dehydration caused by dysphagia. Hartzler says: “my entire existence was doing the exercises and trying to tolerate the feeding tube. The worst thing was wondering if I would ever be able to eat the foods I love again.”
One of the most well-known side effects of dysphagia is the risk of aspiration, commonly known as “food going down the wrong way.” Although aspirating food or liquids is the most often discussed side effect of dysphagia, “oral bacteria can be aspirated and that is more likely to cause illness than food or drink; brushing teeth several times a day, even if the person is receiving a feeding tube, is so important,” Smith says.
Mental health issues often arise with swallowing disorders as well, which is why the focus of treating dysphagia has become more holistic in recent years. “Patients are mourning the loss of swallowing and need to be seen as more than just an airway,” Smith says.
Katherine Gould, whose 80 year old father suffers from dysphagia as a side effect of Multiple System Atrophy, says the use of the Provale cup has helped the state of her father’s mental health.
In the past 30 years, we have learned much about dysphagia and the different treatments of it. It has become the norm to involve patients in their own care planning, as healthcare providers have recognized that swallowing disorders impact a person’s mental and social stability, as well as their overall nutritional health.
Virginia Stewart is the Director of Marketing for ProvaMed.