For most people, swallowing is an act that requires no special effort. For those with swallowing problems (dysphagia), however, it can be a difficult and arduous task that directly impacts nutrition and hydration. When swallowing foods, liquids or even one’s own saliva is difficult, it can affect physical health and create social and emotional problems.
People who are most likely to develop swallowing problems are those with neuromuscular conditions or diseases, including stroke, traumatic brain injury, Parkinson’s disease, multiple sclerosis, amyotrophic lateral sclerosis (Lou Gehrig’s disease), myasthenia gravis, progressive supranuclear palsy and Guillain-Barre syndrome. Patients who have had radiation treatment for head or neck cancer are also prone to dysphagia.
Treatment for dysphagia traditionally involves teaching patients strategies to aid in the swallowing process. For example, it may help to change the consistency of food and liquids, position the head in a certain way when eating or drinking, control the amount of food or liquid taken in each bite or sip, eat slowly, and drink additional liquid after each swallow to clear out any residue. There are also exercises that increase the strength and coordination of muscles in the throat to reduce delays in triggering the swallow, direct food and liquid to the right pathway, protect the airway during the swallow, and open the muscle at the top of the esophagus to allow food to pass to the stomach.
The most advanced treatment for dysphagia is neuromuscular electrical stimulation (NMES). Utilizing the VitalStim® program, external electrical stimulation is delivered to muscles of
the neck through electrodes placed on the skin at specific points. This stimulation elicits contractions and “re-educates” muscle function. Patients also practice eating and drinking and perform other exercises with the electrodes in place. The therapy program is intense, usually scheduled three times a week for 18 sessions. Although improvement is not guaranteed, NMES has been shown to be an effective addition to the treatment of swallowing disorders for many patients.
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VitalStim® therapy has been cleared by the FDA since 2001. All staff in the Speech & Hearing Center at Phelps have completed this specialty program for dysphagia therapy, which is now accredited by the Institute for Credentialing Excellence. Before a patient can be assessed as to whether he or she is a candidate for NMES therapy, a radiology test called a Modified Barium Swallow study is required.
For more information about NMES, call the Speech & Hearing Center at Phelps at 914-366-3010.
