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Adult Dysphagia Multidisciplinary Team



Adult Dysphagia Multidisciplinary Team

Dysphagia can be caused by structural, functional or combination of both. The structural component could be external or internal structural causes producing pressure in the swallowing mechanism. The functional causes of dysphagia may be related to the neuromuscular function of the pharynx and esophagus. Dysphagia or difficulty in swallowing can compromise hydration of the patient and can also lead to aspiration pneumonia.

The National Foundation of Swallowing Disorders has placed the incidence of dysphagia at 22 percent for the population above the age of 50. (Ref. 1) Ten million Americans are presently being evaluated for swallowing problems. (Ref. 1) Although dysphagia can occur at any age, it’s diagnosis, treatment, and management, depends on the cause of the dysphagia.

Learn About Adult Dysphagia

Structural causes of dysphagia are tumor, post-surgical swelling, infection, esophageal diverticulum, Zenker’s diverticulum, bone osteophytes, surgical hardware around the pharynx and the esophagus, vascular compression, rings and webs, reflux, pectic stricture, previous trauma, or surgery in the esophagus.
Functional causes of dysphagia are stroke or cerebrovascular accident, peripheral neuropathies, amyotrophic lateral sclerosis, post-poliomyelitis, multiple sclerosis, achalasia, esophageal spasm, esophageal motility disorders, idiopathic apersistalsis, diabetes, Parkinson’s disease, medications, esophagitis, and scleroderma.
1. Coughing during or after drinking or eating
2. Weight loss and or dehydration because of difficulty in swallowing
3. Food getting stuck in the throat
4. Wet or gurgling voice either or during eating or after eating
5. Painful swallowing (Odynophagia)
6. Hoarseness
7. Sensation of food being stuck behind breastbone
8. Persistent choking sensation
9. Painful swallowing
10. Food regurgitating back to the mouth or throat
11. Drooling
12. Recurrent pneumonia
13. Lengthy feeding or mealtimes
14. Difficulty in swallowing pills
Because of the various symptoms of dysphagia which encompasses or involves several organ systems like the oral cavity, the oropharynx, the larynx, the esophagus and the stomach, the Milton J. Dance Head and Neck Center, offers a comprehensive multidisciplinary and integrated team in the management and treatment of dysphagia. The Dysphagia team is composed of ENT doctors, Gastroenterologist, Laryngologist, Nutritionist, Social Services, and Speech and Swallowing Language pathologist.
Depending upon the patient’s presentation, work-up may include the following:

1. Modified Barium Swallow (MBS) or Video Fluoroscopic Swallowing Exam (VFSE) is a noninvasive exam that looks at the safety and effectiveness of swallowing using different texture and thickness of barium coated food in real time using fluoroscopy. (Ref. 2)
2. Nasopharyngoscopy is a diagnostic medical procedure that involves the examination of the internal structures of your nose and throat. It is a flexible instrument that is inserted in the nose to examine the nasal cavity, nasopharynx, oropharynx, and the larynx. (Ref. 3)
3. Esophagogastroduodenoscopy (EGD) is the use of a flexible scope that is passed in your oral cavity under sedation or local anesthesia that is sprayed in your mouth to examine your pharynx, esophagus, stomach, and duodenum. (Ref. 4)
4. Functional endoscopic evaluation of swallowing (FEES) is an exam in which a flexible scope is inserted either by your speech language pathologist (SLP) or your ENT doctor through your nose. This is followed by swallowing of food and liquid. During this examination, the SLP checks on the passage of the food, coordination of swallowing in the oropharynx, and risk of aspiration. (Ref. 4)
5. Esophageal manometry is the test that is used to monitor the function of the esophagus, lower esophageal sphincter, esophageal pressures, and esophageal muscular peristalsis. Your nose will be anesthetized with local anesthesia and a small 4mm diameter tube is inserted in your nose and is pass down to your stomach. (Ref. 5)
6. Imaging Scan like CT scan or MRI scans will be requested if clinically indicated.


REFERENCES
1. National Foundation of Swallowing Disorders. Swallowing Disorder Basics; 2022. http://swallowingdisorderfoundation.com/about/swallowing-disorder-basics/. Updated May 2022. Accessed May 8, 2022.
2. Radiology Info. Video Fluoroscopic Swallowing Exam (VFSE)/Esophagogram; 2022. https://www.radiologyinfo.org/en/info/modbariumswallow. Updated 2022. Accessed May 8, 2022.
3. Medicine Net. What Is a Nasopharyngoscopy? 2022. https://www.medicinenet.com/what_is_a_nasopharyngoscopy/article.htm. Updated. Accessed May 8, 2022.
4. Medline Plus. EGD - Esophagogastroduodenoscopy; 2022. https://medlineplus.gov/ency/article/003888.htm. Updated 2022. Accessed May 8, 2022.
5. Cleveland Clinic. Esophageal Manometry Test; 2022. https://my.clevelandclinic.org/health/diagnostics/4952-esophageal-manometry-test. Updated 2022. Accessed May 8, 2022.

Our Team

Select a provider below to learn more
Ray G Blanco, MD, FACS
Ray G. Blanco, MD, FACS
Medical Director - Milton J. Dance, Jr. Head & Neck Center, Head and Neck Surgery
Head & Neck Surgery
Surgery
Ray G Blanco, MD, FACS
Ray G. Blanco, MD, FACS
Medical Director - Milton J. Dance, Jr. Head & Neck Center, Head and Neck Surgery
Head & Neck Surgery
Surgery
Niraj D Jani, MD
Niraj D. Jani, MD
Chief, Division of Gastroenterology
Gastroenterology
Niraj D Jani, MD
Niraj D. Jani, MD
Chief, Division of Gastroenterology
Gastroenterology
Lee M Akst, MD
Lee M. Akst, MD
Laryngologist
Lee M Akst, MD
Lee M. Akst, MD
Laryngologist
Farzad A Masroor, MD
Farzad A. Masroor, MD
Head & Neck Surgery
Farzad A Masroor, MD
Farzad A. Masroor, MD
Head & Neck Surgery
Lisa Clossey, MS, CCC-SLP
Lisa Clossey, MS, CCC-SLP
Senior Clinical Manager - Milton J. Dance, Jr. Head & Neck Center
Senior Speech-Language Pathologist
Megan Dasgupta, MS, CCC-SLP
Megan Dasgupta, MS, CCC-SLP
Senior Speech-Language Pathologist
Jordan M. Differding, MS, CCC-SLP
Jordan M. Differding, MS, CCC-SLP
Senior Speech-Language Pathologist
Jason Kortte, MS, CCC-SLP
Jason Kortte, MS, CCC-SLP
Speech Coordinator
Ana Minisci, MS, CCC-SLP
Ana Minisci, MS, CCC-SLP
Senior Speech-Language Pathologist
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