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Swallowing Disorders

 

At the Voice Assessment Centre we specialise in swallowing problems and will work with you to assist your swallowing problem. This will involve us taking an extensive case history, reviewing any previous medical tests and undertaking assessment at the clinic to identify your specific difficulty. This may involve examining your throat structure and muscles as you swallow your saliva or very small amount of food with the nasendoscope - a  small scope placed through the nose and resting at the back of your throat whilst you speak and swallow. This is recorded and played back to you, allowing us to give feedback and advice about management of your swallow problem.

Swallowing itself is a complex mechanism. It involves nerve supply from the brain to the swallowing structures, in particular the tongue, soft palate and larynx. Reduction in function or sensation of these structures may cause coughing violently, persistent  throat-clearing and even aspirating, that is, having food, drink ‘going down the wrong way’ into the larynx or the lungs. This is of concern as there is high risk of a chest infection or pneumonia. It  is vital to identify and  treat any swallowing problems as soon as possible.

Safe swallowing’ strategies may assist as advised by the Swallowing team. It is vital to have your specific difficulty identified to ensure you get  the most relevant advice.

Here are some swallowing tips to try-


1. Head/ Body positioning


  • keep your head level or tilted slightly forward, avoid letting your head lean back-wards, even momentarily when you swallow. This action exposes your airway to food.
  • keep your trunk at approximately 90 degrees whenever possible, especially when drinking liquids. Sit upright in a firm chair with head erect, both feet firmly on the floor. Avoid eating or drinking when reclining.


2. Mealtimes


  • take one bite at a time, “think” about each bite. Allow more time for meals. Avoid distractions when eating . Never hurry!
  • keep your jaw closed whenever possible. 

  • swallow often, this avoids over-chewing your food and drying out your mouth.
  • while eating, watch for seepage of liquids at your lips, avoid the jaw being open, or your head down as this tend to exaggerate any drooling problem. 
  • if moving the food from front to back is a problem, suck your cheeks inward and consciously “think” through the following steps. Tongue tip up, pull back the tongue,   back of the tongue up. Be careful of food falling off of the back of tongue before you are ready to swallow. Place the food in the mid-to-back area of the tongue. 
  • when executing a swallow, head slightly bent forward and gently hold your breath on the swallow.
  • if it is difficult to move food in your mouth, perhaps a change in food consistency or change in food temperature can help. 


3. Do’s and Don’t’s


  • Don’t drop the food in the back of your tongue. Firmly run the spoon from the front to the back of the tongue with a slow movement.
  • if taking tablets with water is a problem, experiment with placing the pill in a small bite of mashed potatoes or pudding. 
  • if thin liquids seem to make you choke more readily, change to thicker liquids. 
  • keep throat moist, a dry throat can make it hard for food to pass without sticking. 
  • remember to keep drinking fluids throughout the day to prevent dehydration or thick secretions. 
  • don’t breathe in when you are in mid-swallow. Complete your chewing and swallowing before you take a breath.