Eating Drinking and Swallowing Problems

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What to expect

Eating, Drinking and Swallowing Difficulties

Some people may not be able to eat, drink and swallow effectively or safely, this is known as an eating, drinking and swallowing difficulty and is also termed dysphagia.

What are eating, drinking and swallowing difficulties?

Eating, drinking and swallowing difficulties occur when an individual cannot pass food or drink safely from their mouth to their stomach. The normal swallow has three phases including:

  • Oral phase: where the individual will prepare the food or liquid in the mouth by chewing or sucking for it to be passed into the throat.
  • Pharyngeal phase: this is where the swallow is initiated, the food or liquid passes through the throat and the air way is closed off in order to protect food or liquid from going down the wrong way.
  • Oesophageal phase: is where the relaxing and contracting of the muscles of the feeding tube causes the food or drink to be passed through the oesophagus and into the stomach.
  • An eating or drinking problem can occur at any of the three stages of the swallow. Eating, drinking and swallowing problems can occur in both children and adults.
  • Common characteristics of eating, drinking and swallowing difficulties include:

    Adults

    • Coughing or chocking when eating or drinking.
    • The feeling that food or liquid is stuck or lodged in the lower neck.
    • A ‘wet' or ‘gurgly' sounding voice when eating and drinking (or just after).
    • Holding food or liquid in the mouth for a long period of time without swallowing it.
    • Having to clear the throat regularly when eating and drinking.
    • Having to swallow several times for one mouthful of food or drink.
    • Food or drink falling out of the mouth.
    • Tiring easily when eating or drinking.

    Babies and Children

    • Stiffening of the body during feeding.
    • Getting irritated or lacking alertness during feeding.
    • Refusing to eat or drink.
    • Being specific about what types of texture of food they eat.
    • Coughing or gagging during feeding.
    • Gurgly, breathy or hoarse sounding voice.
    • Vomiting and spitting out food regularly.
    • Recent pneumonia or respiratory problems.

    Individuals with eating and drinking difficulties are at higher risk of aspiration (when food goes down in to the wind pipe) and at an increased risk of chest infections and pneumonia.

    What conditions can cause eating, drinking and swallowing difficulties?

    Any condition which can cause muscle weakness or nerve damage can result in eating and drinking difficulties. Conditions in children and adults which can cause eating and drinking difficulties include:

    Children

    • Neurological problems
    • Autism spectrum disorders
    • Eating, drinking and swallowing difficulties
    • Speech disorders
    • Learning difficulties
    • Down syndrome
    • Physical disabilities
    • Cleft lip and palate
    • Voice disorders

    Adults

    • Neurological problems
    • Eating, drinking and swallowing difficulties
    • Voice problems
    • Speech disorders
    • Autism spectrum disorders
    • Head and neck cancer
    • Palliative care needs
    • Physical disabilities
    • Learning difficulties
    • Mental health problems

    How are eating, drinking and swallowing difficulties diagnosed?

    Eating, drinking and swallowing difficulties are diagnosed by a medical team of professionals. The speech and language therapist is the main professional who will assess if an individual has an eating drinking or swallowing difficulty. The speech and language therapist will carry out an initial assessment which will include an observation and physical examination of an individual's eating and drinking abilities. The speech and language therapist may also refer the individual for a videofluoroscopy (a specialist x-ray which looks at an individual's swallow in more detail). The speech and language therapist will be able to investigate the cause of the eating, drinking and swallowing problem and also what area of the swallow it is affecting.

    How can speech and language therapy help with eating, drinking and swallowing difficulties?

    Speech and language therapy can support and advise on eating, drinking and swallowing difficulties. The main aim of speech and language therapy for an individual with eating, drinking or swallowing difficulties is for the individual to be eating and drink as safely as possible.

    Speech and language therapy input is essential due to the high risk of aspiration in individuals with eating and drinking difficulties.

    The speech and language therapist will work closely with a team of medical professionals, the individual and also the individual's family in ensuring they gain the best outcome regarding their eating, drinking and swallowing needs.

    Speech and language therapy will be individualised for each client and will consider factors such as their current and past eating and drinking abilities and also the underlying condition causing their eating, drinking and swallowing difficulties.

    In more severe cases of eating, drinking and swallowing difficulties where an individual cannot eat or drink at all, the speech and language therapist and other medical professionals will decide upon the best option of alternative feeding. The individual and their carers will be involved in the decision making process regarding their treatment plan at all times.

    What speech and language therapy treatment can benefit eating, drinking and swallowing difficulties?

    There are many forms of speech and language therapy which can help and support an individual with eating, drinking and swallowing difficulties. Each treatment plan will be specifically tailored to the individual's specific eating, drinking and swallowing needs. Types of speech and language therapy treatments that are available for individuals with eating, drinking and communication needs include:

    One to one therapy

    One to one therapy will involve the therapist and the individual (and their carer or parent). One to one therapy will work on specific areas of communication the individual is finding difficult and also areas they feel are a priority to work on in therapy. For an individual with comprehension problems, the therapist may work on increasing the individual's understanding of spoken and written words, sentences and also conversation and paragraphs.

    Find out more about one to one therapy.

    Group therapy

    Group therapy will usually involve a group of individuals with similar communicative abilities. Group therapy can help in increasing the individual's motivation, social skills and also help to generalise the skills learnt in one to one therapy. Parent and carer groups may also be carried out to help support the parents and carers in supporting the individual's comprehension problems.

    Find out more about group therapy.

    Alternative and Augmentative Communication

    Alternative and augmentative forms of communication may also be used for individuals with very limited and restricted understanding. Alternative forms of communication will help to support an individual's understanding and help them to communicate to the best of their ability. Alternative forms of communication may include visual aids, sign language and also computer aids.

    Find out more about Alternative and Augmentative Communication.

    Speech and language therapy may also include the following:

    • Assessments
    • School visits
    • Clinic visits
    • Home visits
    • Reports
    • Review
    • Early intervention

    How do I arrange a speech and language therapy assessment?

    To arrange an initial assessment with one of our speech and language therapists then please contact us on 0330 0885 643.

    Summary

    A comprehension problem is a difficulty in understanding verbal, non-verbal and written forms of communication. An individual with a comprehension problem will have difficulty in communicating effectively with others. The speech and language therapist will aim to increase the individual's understanding and maximising their communicative ability. If you feel you may benefit from speech and language therapy, then please contact us by emailing office@slt.co.uk or calling 0330 0885 643.





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    To speak to a Speech and Language Therapist or to book an appointment, call us on 0161 883 0111 or email office@slt.co.uk

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