Potential Symptoms of Dysphagia
by Katrina M. Jensen, Fort Worth, Texas, USA
The symptoms listed here are the most commonly reported , although any perceived difficulty eating/swallowing should be reported to your healthcare provider for further evaluation.
1. Longer than standard meal times
This extended meal time may be the result of multiple swallows required to pass a single bolus (mouthful) of food. There may also be smaller than normal bites required or excessive chewing involved to ensure the food is able to pass through the throat. In many cases, this extra time for meals is required, but it is important to bring this issue to the attention of your healthcare provider for further evaluation.
2. Sensation of food/liquid remaining in the throat following the swallow
This may be a natural collection within a pocket of the throat, or it could be a symptom of a different issue. In either case, this should be further evaluated. In the case of normal collection, there are often techniques and strategies that can assist with this, once properly identified.
*food collection within the throat should not be considered “normal” until the nature of this has been evaluated and established.
3. Difficulty swallowing solids
This is a common complaint which may arise from pharyngeal weakness and/or an esophageal problem. The treatment for these separate issues is quite different and adequate diagnosis is required before proper intervention can be conducted .
4. Regurgitating solids after attempting to swallow
This is a common complaint which may arise from pharyngeal weakness and/or an esophageal problem. There may also be normal pocketing in the throat. The treatment for these separate issues is quite different and adequate diagnosis is required before proper intervention can be conducted[1, 2].
5. Food/liquid coming through the nose
This can often be the most alarming of dysphagia symptoms, both to the patients as well as the family/caregivers. This is an indication that food/liquid material is not passing effectively into the esophagus. As the material builds up in the throat, the material will continue to collect until it rises to the level of the nasal passages where it is able to drain through the nose from the throat. This is a significant symptom of dysphagia, although should not cause particular alarm. Once the reason for the dysphagia is properly evaluated, this can typically be treated and resolved.
6. Painful swallowing
This is most often reported within the weeks following surgery and/or during a course of post-operative radiation. Although it may be an anticipated symptom, in the case of head and neck cancer patients, this should always be thoroughly evaluated, especially when reported in combination with any of the above symptoms of dysphagia.
7. Change in swallowing
Although this may not be an indication of a problem, patients should always report any changes in their swallowing pattern; for example, those who find themselves no longer able to swallow certain foods/textures with typical ease, or are avoiding certain foods that were well swallowed before. In many cases, these changes can be well managed but it is important to be identified as early as possible.
Although these are the most commonly reported dysphagic symptoms in the laryngectomee population [1, 3], any change or issue you may be noticing in how well you are able to swallow should always be reported to your healthcare provider. In many cases, potential issues identified early are better managed with early intervention, than after being allowed to progress to more significant levels.
1. Sullivan, PA; Hartig, GK; “Dysphagia after total laryngectomy”; Current Opinion in Otolaryngology & Head & Neck Surgery: June 2001 - Volume 9 - Issue 3 - pp 139-146
2. Oursin, C; Pitzer, G; Fournier, P; Bongartz; G, Steinbrich, W; “Neopharyngeal pseudodiverticulum: A possible cause of dysphagia in laryngectomized patients”; Clinical Imaging; Volume 23, Issue 1, pp15-18
3. Bajaj, Y., Shayah, A., Sethi, N., Harris, A. T., Bhatti, I., Awobem, A., Loke, D., & Woodhead, C. J. (2009). Clinical outcomes of total laryngectomy for laryngeal carcinoma. Kathmandu University Medical Journal, 7(3), 258-262.
4. Johnson, AF; Jacobson, BH; Medical speech-language pathology: a practitioner’s guide; pp.198-200; Thieme Medical Publishers, Inc; New York, NY; 2007