Treatment of oropharyngeal dysphagia depends on the etiology and the severity of the problem. An essential component of treatment is education of the patient, family, and other caregivers regarding the nature of the swallowing problem, its potential complications, and the importance of following recommendations to prevent such complications. Treatment may also involve one or more of the following:
An exercise program to improve the strength, range of motion, speed, and/or coordination of movements.
Diet modifications that eliminate food or liquids of consistencies that are at high risk of being aspirated.
Teaching of specific postures or strategies designed to reduce or eliminate the risk of aspiration when swallowing.
Use of an alternate means of feeding, such as a gastric tube, either temporarily while other treatment strategies are attempted, or permanently if other treatment is unsuccessful.
Esophageal dysphagia is usually medically, rather than behaviorally, managed. Dilatation is the typical treatment for esophageal stenosis. Surgery is most often used for esophageal tumors. Medications are used to treat motility disorders. Achalasia may be treated with smooth muscle relaxant drugs, dilatation, or surgery. Gastroesophageal reflux disease may be managed through dietary and lifestyle modifications, specifically: decreasing or eliminating certain foods from the diet, elevating the head of the bed for sleeping, avoiding lying down within two hours of eating, and eliminating smoking. Drugs and surgery are also used to treat this disorder.
The prognosis for recovery from dysphagia varies from excellent to poor depending on its severity, etiology, and the ability of the individual to comply with treatment recommendations.
Mary Boyle Ph.D., CCC-SLP, BC-NCD, The Gale Group Inc., Gale, Detroit,