Oropharyngeal dysphagia is the inability to swallow food or drink. The condition can also cause breathing difficulties, choking, and drooling. Oropharyngeal dysphagia can occur due to various conditions, including a stroke and Parkinson’s.
The oropharyngeal airway refers to the pharynx, the hollow tube inside the neck that starts behind the nose and stops at the top of the windpipe and esophagus.
This article examines the symptoms, causes, and treatment options for oropharyngeal dysphagia. It also looks at how doctors diagnose the condition and answers some frequently asked questions about it.
Symptoms of oropharyngeal dysphagia can vary depending on the cause.
Some of the symptoms include:
- difficulty swallowing food or liquids
- noisy breathing
- regurgitation, sometimes through the nose
- weight loss
- feeling like there is something stuck in the back of the throat
Oropharyngeal dysphagia may be due to neurologic, neuromuscular, or structural impairments.
A 2017 article notes that it can affect:
- over 30% of those who have had a cerebrovascular accident
- 52–82% of those with a neurogenerative condition
- more than 35% of those with a head or neck condition
- over 60% of older adults in nursing homes
Some conditions that can cause oropharyngeal dysphasia include:
- head injury
- multiple sclerosis (MS)
- gastroesophageal reflux disease (GERD)
- amyotrophic lateral sclerosis (ALS)
- muscular dystrophy
- head and neck tumors
- cerebral palsy
- hypotonia, which refers to a low level of muscle tone
- tonsilar hypertrophy, or swollen tonsils
Treatment for oropharyngeal dysphagia can be challenging because it has a neurological cause.
- Changes to a person’s diet: Some foods and liquids are easier to swallow than others. However, swallowing liquid can also be challenging for someone with oropharyngeal dysphagia, as they may breathe it in. It is important to consume easy-to-swallow foods while still maintaining a well-balanced diet. A person can discuss which types of food and liquids to consume with a doctor.
- Focusing on posture: Postural control can help improve certain aspects of swallowing.
- Swallowing therapy: Swallowing therapy is a way to help people with swallowing problems. Speech and language therapists will train people on new ways of swallowing, which will build up the muscles that are weak or not working properly. Following a swallowing exercise routine will also help improve the person’s swallowing ability.
- Dental and oral care: Good oral care can help to improve a person’s swallowing and cough reflex. It can also help to reduce bacterial overgrowth.
Some people at risk of malnutrition, dehydration, or pneumonia may require a feeding tube. A healthcare professional will insert a nasogastric tube through the nose into a person’s stomach, but PEG tubes require surgery to implant into the stomach.
Diagnosing oropharyngeal dysphagia can be difficult. However, there are several different ways healthcare professionals can determine if a person has oropharyngeal dysphasia, including:
- Medical history: Healthcare professionals will ask the person how long they have been experiencing difficulty swallowing. They will also want to know if it occurs only with certain foods or liquids and if the person has lost weight recently, potentially due to the condition.
- Feeding evaluation: A speech therapist will ask the person to try to consume many different foods and liquids and note what happens as they do. This way, they can see where the difficulty lies.
- Endoscopy: An ear, nose, and throat specialist can insert a flexible camera to view the throat and esophagus to investigate potential causes of oropharyngeal dysphagia. They may also do this alongside a functional endoscopic evaluation of swallowing test, which helps to assess how well a person is swallowing.
- Barium swallow test: Doctors may order a barium swallow test. In this test, the person will swallow a liquid, solid, or puree that is mixed with or coated in barium. This will show on an X-ray and allow healthcare providers to see the muscles moving.
Tests can also help determine if there are other causes for difficulty swallowing, such as an obstruction in the throat or esophagus.
If oropharyngeal dysphagia is left untreated, several complications may occur. Some of the complications that can arise due to oropharyngeal dysphagia
- Malnutrition: If a person is not getting enough nutrients from food, they run the risk of malnutrition. Malnutrition is especially prevalent in people who are unaware that they have oropharyngeal dysphagia. In this case, it will be untreated and so continue to worsen.
- Aspiration pneumonia: When a person breathes food or liquid into the airways or lungs rather than swallowing, it can cause aspiration pneumonia.
- Dehydration: If a person can not swallow liquids, they may become dehydrated due to insufficient water entering their body.
These complications can be very serious, so people with oropharyngeal dysphagia must seek treatment as soon as possible.
The outlook for people with oropharyngeal dysphagia depends on the underlying cause.
According to a
Swallowing therapy may not be as effective in those with neurodegenerative conditions. However, it may benefit those with age-related muscle and strength loss.
The authors suggest that further research can improve the outlook of oropharyngeal dysphagia.
Here are some frequently asked questions about oropharyngeal dysphagia.
Vs. oral dysphagia
Oral dysphagia is a subtype of oropharyngeal dysphagia. Whereas oropharyngeal dysphagia affects the mouth or throat, oral dysphagia impacts the mouth alone.
This sometimes develops due to tongue weakness after a stroke.
Vs. pharyngeal dysphagia
Pharyngeal dysphagia is a subtype of oropharyngeal dysphagia. It is an inability to push food from the mouth into the esophagus.
This may be due to neurological conditions, such as a stroke, or muscular difficulties, such as cerebral palsy.
Vs. esophageal dysphagia
Also called low dysphagia, esophageal dysphasia impacts the esophagus.
Esophageal dysphagia may make people feel that they have something stuck in their throat. It can develop due to a blockage in the esophagus or irritation there.
People with esophageal dysphagia may need surgery to resolve this.
Oropharyngeal dysphagia is when a person has difficulty swallowing due to damage to the oropharynx or throat.
This can happen due to stroke, Parkinson’s disease, or other neurological conditions that affect muscle control in the mouth and throat.
People can work with medical professionals to find ways of swallowing safely without aspiration.
People with oropharyngeal dysphagia might find eating smaller and more frequent meals helps. It is also important to eat slowly.