Dysphagia therapy, a form of physical therapy designed to help people with swallowing disorders, includes direct, indirect, and compensatory techniques. In addition, some people with dysphagia benefit from other treatments, including surgery, dietary modifications, and drug therapy, depending on the underlying cause of the swallowing disorder. Treatment is usually overseen by a speech-language pathologist and can also involve doctors with experience in caring for patients with esophageal disorders.
One of the most common causes of swallowing disorders is stroke, where the nerves in the jaw and throat are damaged and the patient has difficulty swallowing as a result. Some medications can cause swallowing problems, as can disorders like esophageal stricture, where the esophagus narrows in response to chronic irritation and inflammation. Treatment for dysphagia starts with a comprehensive medical evaluation to find out why the patient is having trouble swallowing.
Compensatory dysphagia therapy involves teaching the patient techniques to compensate for swallowing problems, such as tilting the head or sitting differently to facilitate swallowing. People with strokes who cannot expect significant improvements in swallowing ability can achieve a higher level of independence by learning to compensate. Patients can also benefit from direct dysphagia therapy, learning exercises to use while swallowing. This can include exercises for the throat, jaw, and tongue.
Indirect dysphagia therapy uses exercises while people are not eating to increase motor control and strengthen the muscles used in swallowing. These exercises are performed on a regular basis with the goal of helping the patient swallow more easily and comfortably. All three forms of therapy can be combined in the treatment of some patients, depending on their situations and how they respond to treatment over the course of therapy.
Patients with narrowed esophagi sometimes benefit from a surgery to widen the esophagus, or from the placement of a stent to hold the through open if the patient does not respond well to surgery. Making dietary modifications and selecting foods that are easier to chew and swallow can help. In some cases, drug treatment may resolve the problem; patients may be taken off drugs causing swallowing disorders or put on drugs to treat underlying medical conditions linked with dysphagia. Successful dysphagia therapy can take weeks or months of treatment with periodic adjustments as the patient responds to the treatments and it requires cooperation on the part of the patient. If patients have trouble adhering to a treatment plan, it will not be as successful.
