Dysphagia Awareness Month
On September 27, 2008, the US Congress passed a bipartisan statute which declared June as National Dysphagia Awareness Month. Dysphagia Awareness Month provides an excellent opportunity to raise awareness about what dysphagia is, its symptoms, causes, available treatments, and the roles of the various professionals who can help those with dysphagia.
Among 235 million adults in the United States, approximately 9.4 million reported swallowing problems, only 19.2 % of whom reported receiving treatment or therapy for their swallowing problem. Significant age, racial, gender and socioeconomic disparities exist with respect to the self-reported prevalence and treatment of swallowing problems among adults in the United States. Targeting underlying risk factors for dysphagia must also involve determining strategies to address barriers in access to care. Female gender, older age, lower income level, public insurance status and unemployment were independently associated with increased odds of reporting dysphagia, while also associated with decreased odds of receiving treatment. (i)
Dysphagia is not limited to adults but is also prominent in children with histories of preterm birth, neurologic and neuromuscular diagnoses, developmental delays, and aerodigestive disorders; and is associated with medical, health, and neurodevelopmental problems; and long-term socioeconomic, caregiver, health system, and social burdens. (ii)
Common signs and symptoms of dysphagia include, but are not limited to unintentional weight loss, coughing during or after meals, recurrent lung infections, liquid/food coming out of nose/mouth, liquid/food coming back up into mouth or throat after its been swallowed (regurgitation), avoiding foods once enjoyed, and feeling of food remaining “stuck”.
Dysphagia is a symptom caused by various diseases/conditions, which in adults, include head and neck cancers, pulmonary conditions (e.g., chronic obstructive pulmonary disease), and a variety of acquired neurologic conditions such as stroke, dementia, ALS, and Parkinson’s disease. Unfortunately, swallowing symptoms may develop gradually over time and so dysphagia often goes unnoticed and underreported.
Individuals who have undergone radiation treatment for head and neck cancers, may develop dysphagia many years after that treatment due to radiation fibrosis (scar tissue formation), and if referral to a speech-language pathologist is not part of the early treatment plan, these individuals may miss an opportunity for early intervention which often includes prophylactic swallowing exercises.
How Common is Dysphagia in Parkinson’s?
Up to 80% of Parkinson’s disease (PD) patients develop dysphagia, yet fewer than 10% report symptoms. Patients often under-report swallowing difficulties due to the gradual onset of symptoms, and our body’s ability to adapt or compensate for a while the changes in the system. But, with disease progression and/or cognitive changes that may further reduce awareness, dysphagia may progress and include episodes of aspiration (food or liquid getting into the lungs). Even drooling, which is a common symptom reported by people with PD, represents an early change to the efficiency of the swallowing mechanism, and should trigger a referral to a speech-language pathologist for a swallowing evaluation.
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If you are having difficulty swallowing, notify your primary care physician or neurologist who will refer you to appropriate professionals which may include GI (gastroenterology); ENT (Ear Nose, and Throat), and Speech-language pathology.
(i) Melissa Zheng, Sheng Zhou, Kevin Hur, Tamara Chambers, Karla O’Dell, Michael Johns, Disparities in the prevalence of self-reported dysphagia and treatment among U.S. adults, American Journal of Otolaryngology, Volume 44, Issue 2,2023,103774,ISSN 0196-0709 https://doi.org/10.1016/j.amjoto.2022.103774.
(ii) Lefton-Greif, M.A., Arvedson, J.C., Farneti, D. et al. Global State of the Art and Science of Childhood Dysphagia: Similarities and Disparities in Burden. Dysphagia (2024). https://doi.org/10.1007/s00455-024-10683-5
National Foundation of Swallowing Disorders (NFOSD)
Our Mission: “Advancing the treatment of swallowing disorders in our lifetime.”
NFOSD is a grassroots organization whose purpose is to provide patient hope and improve quality of life for those suffering from all types of swallowing disorders, by enhancing direct patient support, education, research and raising public, professional, and governmental awareness. They serve as a tremendous resource for professionals and individuals with dysphagia and their families. Please visit their website to learn more about educational opportunities and support groups. https://swallowingdisorderfoundation.com/
My Mission: To enlist individuals in their treatment, and help them express their personality & spirit through voice. To educate and empower. Mary Spremulli, MA, CCC-SLP * FiTOUR® Group Exercise Instructor * Certified End of Life Specialist (CEOLS) * Voice Aerobics® A Whole Body Approach to Voice Practice