Dysphagia is a difficulty in swallowing that can affect people under all age groups. It can be related to solid foods only, or even to the semi-liquid or liquid ones. Normal swallowing involves the coordinated and synchronized participation of oropharyngeal, laryngeal and esophageal muscles, with the cud occurring about 150 times within 24 hours. However, the unconscious saliva swallowing occurs every 30 seconds while awake and every minute during the sleep, therefore about 1600-2000 times within 24 hours. The symptoms that should prompt the suspicion of dysphagia include:
- involuntary coughing every 2-3 minutes after swallowing a mouthful;
- veiled or gurgling voice after swallowing the mouthful;
- spillage of food or liquid from the nose;
- increase in body temperature without apparent cause;
- increased salivation;
- secreted phlegm.
The causes of dysphagia can be divided into obstructive, as, for instance, the decrease in the lumen of the upper digestive tract (esophagus in particular) and movement-related. The first category encompasses the foreign bodies, strictures, tumors, diverticula, inflammation, enlargement of the thyroid, cervical spondylitis. In the second group we find the functional outcomes of systemic diseases, such as polymyositis, amyotrophic lateral sclerosis or scleroderma, and esophageal disorders such as achalasia, diffuse esophageal spasm, or the idiopathic dyskinesias of esophagus. Other causes can be either neurologically-traced, such as the paralysis of the tongue muscles, or polio; or related to neuromuscular disorders, such as myopathy and myasthenia.
On the basis of clinical and instrumental evaluation there was set up a treatment plan consisting of:
- compensation techniques;
- modification of the volume, density and viscosity of the food;
- changes in the diet;
- swallowing maneuvers;
- sensory stimulation techniques;
- exercises to increase the contraction of the muscles.
If dysphagia persists for very long periods, the risk of a rooted malnutrition becomes high enough, and, in order to cover the daily energy and nutritional requirements, it is suggested to consider the nutritional integration and supplementation.
Italian Study Group for Dysphagia: www.gisd.it
The consumption of DMF products for malnutrition and dysphagia such as thickeners in powder or gelled water safely guarantee an appropriate nutrional and water intake.