Today, many people know the dangers of falls in the elderly. A fall can easily lead to a hip fracture or head injury, hospitalization, or even death. But people may not realize that swallowing problems are also responsible for tens of thousands of deaths a year in the United States. This short article will tell you what to look for so that you can get a proper evaluation and treatment for yourself or a loved one before a swallowing problem becomes life-threatening.
We swallow about 600 times a day. It is not something we pay much attention to (if we pay attention at all) because it is very automatic. But as we age, we can detect disorders like Parkinson’s disease, congestive heart failure, lung disease, or Alzheimer’s that interfere with swallowing. It’s not just the elderly who are at risk. Younger people with multiple sclerosis, head injury, or stroke are also vulnerable. To make matters worse, the medications used to treat these and other disorders sometimes complicate the picture. For example, antihistamines like Benadryl (diphenhydramine) can reduce saliva supply and interfere with swallowing at various steps in the process.
Swallowing difficulties (also known as “dysphagia”) can cause death from (1) choking, (2) pneumonia, and (3) malnutrition. By asphyxia we mean a significant blockage of the airways (at the level of the throat or trachea), something that the Heimlich maneuver can prevent from becoming fatal. Pneumonia is usually the result of inhaling (or “breathing in”) bacteria-laden food, liquid, or saliva from the mouth. Malnutrition weakens a person, so they cannot cope with the challenges of infection or recover from cancer and its treatment.
These are questions to ask yourself or a loved one that may suggest a swallowing problem:
(1) Does food sometimes go down the wrong channel?
(2) Does your voice sometimes sound “gurgling” or wet when you eat?
(3) Is eating sometimes less enjoyable than it used to be?
(4) Do you sometimes have trouble removing food from your mouth in one gulp?
(5) Do you sometimes have the feeling that food is stuck in your throat?
(6) Have you had pneumonia or other repeated respiratory illnesses?
(7) Have you ever lost weight without trying?
(8) Do you often have trouble swallowing medications?
(9) Do you choke or cough frequently when eating solid foods?
(10) Do you often have difficulty swallowing a specific food or liquid?
(11) Do your eyes fill with tears when you eat?
(12) Does your nose runny after eating?
(13) Do you clear your throat a lot while eating?
(14) Does it take forever to get through a meal?
If you answered “Yes” to one or more of these questions, please tell your personal physician or other primary health care provider. You may be referred to a swallowing specialist. This may be a speech-language pathologist. These specialists have been trained in swallowing, which involves many of the same muscles and nerves that are involved in speech.
Don’t wait to discuss your questions and concerns with your doctor. These problems tend to persist and get worse. Take action before disaster strikes.
For more information on swallowing problems (dysphagia), visit the American Dysphagia Network at http://americandysphagianetwork.org and read “Swallow Safely: How Swallowing Problems Threaten the Elderly and Others. A Guide to recognition, treatment and prevention of the caregiver “. It is available through http://www.SwallowSafely.com, Amazon.com (including a Kindle edition), and as an iBook.
