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UR Medicine / Otolaryngology (ENT) / Speech Pathology / Our Services / Dysphagia

 

Dysphagia & Swallowing Services

Dysphagia is a swallowing disorder that involves the mouth, throat and / or esophagus. Dysphagia can result from:

  • Stroke
  • Brain Injury
  • Spinal Cord Injury
  • Neurological diseases (Parkinson Disease, ALS, MS, Muscular Dystrophy, Myasthenia Gravis, Dementia)
  • Developmental disabilities
  • Cancer and cancer treatments
  • Trauma
  • Intubation and / or trachestomy
  • Vocal fold paralysis
  • Deconditioning
  • Other diseases

Dysphagia may also be impacted by laryngopharyngeal reflux (LPR) and gastroesophageal reflux, as well as dry mouth, poor dentition and side-effects of medication.

Individuals with dysphagia typically complain of the following:

  • Coughing when eating or drinking or wet vocal quality
  • Choking on food
  • Regurgitation
  • Drooling
  • Feeling food get stuck the throat or chest
  • Difficulty swallowing pills
  • Weight loss or dehydration
  • Increased time to eat meals
  • Having to eat more slowly, take smaller bites, or be very careful when eating
  • Difficulty with particular foods (e.g., meats, bread, lettuce, rice, nuts) or needing to avoid certain foods
  • Frequent pneumonia or other respiratory infections
  • Pain with swallowing

Speech-Language Pathology Evaluation & Therapy

Our Speech-Language Pathologists have specialty training and expertise in evaluating and treating swallowing disorders.

Typically, an outpatient evaluation of a swallowing problem begins with an instrumental swallowing study.  There are two types of instrumental swallowing studies.  Your physician will order the test most appropriate for your particular swallowing complaint.  These tests include:

  • Modified Barium Swallow Study (MBSS) / Pharyngogram – This is a video x-ray study used to assess your ability to swallow food and liquids.  The study is completed by Speech-Language Pathologist, Radiologist, and a Radiology Technologist. During the study you will eat and drink different food and liquid items containing barium.  Barium allows the SLP and Radiologist to see the food and liquid as you swallow under x-ray.
    • These swallowing tests are completed at 200 East River Road, Rochester, NY
    • Additional information, including how to schedule and directions can be found here (insert link)
  • Fiberoptic Endoscopic Evaluation of Swallowing (FEES) - The procedure involves the Speech-Language Pathologist passing a flexible endoscope through the nose, into the throat, so that the voice box and upper airway can be viewed from above.  Once the scope is place, you will be given food, dyed green to contrast against the tissues in the throat, and assesses the function of the swallowing mechanism.
    • These swallowing tests are completed at Clinton Woods, Wilmot Cancer Center and Strong Memorial Hospital

In some instances, your physician may request an in-clinic swallowing evaluation to be completed prior to the instrumental swallowing study.  Assessment will include:

  • A detailed history collection
  • An oral motor examination to assess cranial nerve function that impacts swallowing
  • Trials of foods and liquids, including observation and assessment by the Speech-Language Pathologist during these trials

In most cases following an in-clinic swallowing evaluation, an instrumental swallowing study will be recommended.  This study provides the SLP with additional information in order to develop the most efficacious treatment plan.  For some individuals that may include referral to another service or for additional testing, and for others it may involve compensatory strategies for swallowing or swallow strengthening therapy. 

For individuals referred for swallowing therapy, treatment may include:

  • Education regarding the results of your swallowing evaluation
  • Compensatory strategies to improve your safety with swallowing
  • Targeted strengthening program, including exercises
    • Biofeedback / sEMG – Provides visual feedback on the effort used with exercises
    • IOPI – A targeted tongue strengthening exercise program with visual feedback
  • Respiratory Muscle Strength Training to improve breathing, cough strength and swallow
  • Flutter valve to facilitate clearing of secretions from the airway
  • Stretches to increase range of motion of the muscles involved in swallowing

Additional Resources

American Speech-Language Hearing Association: https://www.asha.org/practice-portal/clinical-topics/adult-dysphagia/#collapse_3

National Institute on Deafness and Other Communication Disorders: https://www.nidcd.nih.gov/health/dysphagia