A MONASH University-led research review found that awareness of dysphagia – swallowing disorders that impair our innate ability to swallow food, drinks, medicine, and saliva – was low and needs to improve.
Dysphagia rarely occurs by itself, and is usually the consequence of medical conditions that affect the brain, such as stroke or dementia, explained speech pathologist Dr Debbie (Dai) Pu.
It can also arise from issues with the muscles and tissues of the head and neck – for example, head and neck cancers.
“Unsurprisingly, most people are not aware of its existence until they or a loved one is affected,” Dr Pu said.
“Unfortunately, this lack of awareness seems to also exist amongst health professionals who could be making timely referrals for the condition.”
A team of speech pathology researchers from Monash, Stanford Healthcare and the University of Hong Kong reviewed studies that have examined this lack of awareness in people who could be affected by dysphagia: patients, their family and friends, health professionals, and people who work in food service.
“And things didn’t look good,” she said.
“Patients could be experiencing terrible difficulties but normalising symptoms that would otherwise be judged as abnormal by their clinicians.
“Family and friends know that patients struggle and are supportive, but may not truly understand how severe and devastating the struggle can be.”
Signs to watch for include coughing, choking or frequent throat clearing during or after eating or drinking; eating slowly; becoming short of breath when eating; avoiding certain foods; unplanned weight loss; and frequent chest infections without obvious reasons.
Dr Pu told Pharmacy Daily that pharmacists have a role in helping patients with dysphagia who have trouble swallowing pills.
“Consider whether a medication is suitable to be altered in texture (for example, by crushing) to help the patient swallow more easily and not compromise its intended effects,” she suggested.
“If the texture cannot be altered, different swallowing aids could be trialled – for example with foods or drinks, or cups that help the pill go down.
“This is best trialled with input from the multidisciplinary team where a speech pathologist can provide input on swallowing safety, and a pharmacist can provide input on possible interactions between the medication and swallowing aids,” she noted.
Dr Pu also pointed out that certain medications – in particular antipsychotics and benzodiazepines – are associated with dysphagia.
“If the effect of the medication on swallowing function is confirmed and significant enough, it’s best for the medical team and the patient to make an informed decision together about whether a medication review is warranted,” she said.
Read the research paper HERE. KB
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