August 7, 2023 Author : Isabel Carvalho Deglutition (swallowing) is a complex mechanism that transports solid foods, liquids and saliva from the mouth to the stomach. It is the first phase of digestion and ensures adequate nutrition and hydration. Several circumstances exist in which swallowing may be compromised. The swallowing difficulty is called dysphagia. Oropharyngeal dysphagia is swallowing difficulty related to the oral or pharyngeal phases of the process, that is, the movement of food and saliva between the mouth and pharynx. Oropharyngeal dysphagia affects: 10%-33% of the elderly; 50%-70% of people who have had a stroke. It is usually caused by a neuromuscular dysfunction that interferes with the coordination of the muscles involved in swallowing. Symptoms and diagnosis Depending on the severity of the situation dysphagia symptoms can include: Difficulty starting swallowing; Sensation of “trapping” when passing food; Cough; Frequent gagging; Pain when swallowing; Unexplained weight loss. These symptoms can lead to various complications, for example: Malnutrition; Dehydration; Aspiration pneumonia; Decreased quality of life. The diagnosis of oropharyngeal dysphagia is performed through a detailed clinical evaluation, which involves: The patient medical history; Perform a physical examination, particularly centered on the structures involved in swallowing; Perform swallowing tests; In some cases, imaging tests, such as swallowing videoendoscopy (VED). VED is a safe endoscopic procedure that uses a small flexible tube - the nasofibroscope - which is inserted through the nostrils into the throat. It allows viewing the structures involved in swallowing and eventually observing anatomical or functional changes in the throat region that may contribute to dysphagia. Treatment of oropharyngeal dysphagia Once a oropharyngeal dysphagia is diagnosed, it is necessary to identify its cause to determine the most appropriate treatment. In most cases dysphagia should be treated by a multidisciplinary team involving: Physicians, generally otorhinolaryngologists; Speech therapists; Nutritionists. Depending on the cause and severity of dysphagia, several therapeutic approaches may be taken, including: Adequation of food textures and consistencies to facilitate swallowing; Training with exercises and specific maneuvers to strengthen the muscles involved in swallowing and improve coordination; Application of tactile, gustatory and olfactory stimuli to improve the sensory response during swallowing and facilitate the swallowing reflex; Treatment with medicines to control symptoms that may be associated, such as laryngopharyngeal reflux In summary… Oropharyngeal dysphagia interferes with the safe passage of food, liquids and saliva and compromises the ability to swallow safely and efficiently. With an early diagnosis and adequate treatment, it is possible to improve the quality of life of patients and minimize the potential risks. The therapeutic approach should be determined based on the particularities of each person, considering the cause and severity of dysphagia, and involving a multidisciplinary team of health professionals. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
