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Science to the power of life.™ June 2008 Common Condition Often Goes Undiagnosed Three-fourths of Dysphagia Patients Left Untreated Despite afflicting more than one in five people over age 50, swallowing difficulties, also known as oral pharyngeal dysphagia, are often left undiagnosed and therefore go untreated. In fact, dysphagia may go undetected in as many as 75 percent of those who suffer from it, according to the Journal of the American Geriatrics Society. Without proper nutritional guidance, patients with dysphagia are at a greater risk for aspiration pneumonia because food particles are more likely to enter their lungs. They are also at risk for choking and experience a decreased quality of life. Detecting Dysphagia To help patients live their best lives, it is important to recognize the symptoms of dysphagia and adjust patients’ diets accordingly. This condition is a secondary diagnosis often associated with the following: • Neurological disease (such as stroke) • Traumatic brain injury • Cervical spinal cord injury • Parkinson’s disease • Alzheimer’s disease • ALS • Cancers of the head and neck • Oral-pharyngeal structural anomalies (such as Zenker’s diverticulum) • Trauma to the swallowing structures and nerves that control them The aging process itself can also lead to a slower and less efficient swallow. Observing patients throughout the day and especially at meal times will help in identifying some of the symptoms of dysphagia. Warning signs to look out for include: • Difficulty managing saliva • Drooling of secretions or food • Delay in swallow initiation • Coughing or choking before, during or after swallowing • “Wet,” gargly voice after swallowing • Food coming out of nose • Complaints of multiple painful swallows • Prolonged eating time/Inability to finish a meal • Food avoidance • Weight loss • Dehydration Mental confusion, garbled speech, acute or progressive neurologic disease and pneumonia, especially in the presence of neurologic disease, also can indicate that dysphagia is present. Any symptoms should be discussed with the patient’s physician, who will likely engage a therapist to ascertain a diagnosis and formulate a treatment plan. Treatment Once a patient is diagnosed, altering the texture of some foods will help them chew and swallow more easily. Certain textures, such as thin liquids, should be avoided entirely. Instant thickeners and pre-thickened beverages provide two solutions to help patients easily consume the amount of fluids they need. The low availability of dysphagia products, however, has historically been a challenge for clinicians who discharge their patients or work in an independent living facility. Today, online resources such as www.Swallowing.NestleNutritionStore.com present easy opportunities to purchase appropriate food products and a resource center to help people learn more about this condition, as well as useful tips, recipes and tools. Pre-thickened beverages and ThickenUp®, two trusted resources to help combat the nutritional challenges of this condition, are readily available on the site and can be delivered directly to shoppers’ homes. By looking out for the warning signs and providing patients with useful resources, clinicians can effectively provide their patients with the support they need while battling dysphagia. Dysphagia information provided by Pat Felt, MS, RD, LD. Felt is a senior professional services specialist for Nestlé HealthCare Nutrition. She served as the chair of the National Dysphagia Diet Task Force and continues to be actively involved in dysphagia work.