Understanding Dysphagia

Dysphagia
Feeding and Swallowing Difficulties

Dysphagia means difficulty in swallowing. Swallowing happens in three phases. A child with Dysphagia can have a problem in either of these stages:

  1. Oral stage: Transporting food or liquid to the mouth and into the throat. (e.g. chewing, sucking)
  1. Pharyngeal stage: Swallowing begins and the food is squeezed down the pharynx (throat). The epiglottis closes off the passage to the windpipe so food doesn’t go into the lungs.
  1. Oesophageal stage: The oesophagus (tube that goes from the mouth to the stomach) squeezes food down to the stomach. 

Dysphagia can cause inability of food and liquids to pass from a child’s mouth to the throat and through the oesophagus to the stomach. 

Causes

Dysphagia is caused by structural problems and weak or damaged muscles/nerves in the mouth, throat, or oesophagus. Dysphagia is most commonly associated with:

  • Brain damage and defects
  • Nervous system disorders e.g. Meningitis
  • Neuromuscular disease 
  • Premature birth or low birth weight
  • Prenatal malformations
  • Heart or lung diseases
  • Head or neck problems
  • Gastro-oesophageal disorders (reflux or other stomach problems)
  • Cleft palate or lip
  • Autism
  • Foreign bodies in the oesophagus
  • Large tongue or tonsils
  • Tumours or masses in the throat
Symptoms of Dysphagia

Symptoms may present differently in every child. Some common symptoms of dysphagia are as follows:

In infants:
  •  Difficulty in sucking and swallowing
  • Gagging during feeding
  •  Drooling
  • Food or liquid coming out of the nose during or after feeding
  • Frequent spitting up or vomiting
  • Irritability while feeding
In children:
  • Trying to swallow a mouthful of food several times
  • Eating slowly
  • Feeling like food or drink gets stuck in the throat or feeling like there’s a lump in the throat
  • Coughing or choking while eating or drinking
  • Chest congestion after eating or drinking
  • Feeling like food or liquids are sticking in the throat or oesophagus or feeling like there’s a lump in the throat
  •  Prone to respiratory infections 
  • Voice changes (Wet or raspy sounding voice) during or after eating during or after eating
  • Frequent respiratory infections
  • Weight loss
Treatment:

The treatment plan usually depends on a child’s age and severity of the symptoms. Specialists such as Speech-language therapists, occupational therapists, gastroenterologists, pulmonologist and paediatricians most commonly treat children with dysphagia.

An SLP or feeding team may suggest:
  • Medical treatment
  • Feeding therapy
  • Changing feeding/eating position
  • Changing texture, temperature or type of food intake
  • Changing feeding equipment or utensils 
  • To get your child to try new foods 
  • Seeing another professional, like a psychologist 
What role can you play:
  • Ask questions from your therapist in order to understand the problems your child has
  • Accompany your child during treatment
  • Follow the suggestions your therapist makes 
  • Discuss your child’s situation at their school and with family members 
  • Discuss your child’s progress with the therapist


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