An ailment that’s hard to swallow

Posted by watchmen
April 15, 2021
Posted in OPINION

Dentists have it right: without good oral hygiene, the body gets sick. 

Those words of wisdom come from Julie Barkmeier-Kraemer, PhD, an expert at the University of Utah Health on swallowing disorders.

Swallowing is not to be taken lightly. After all, it’s the only natural way nutrients and liquids are ingested by the body.

Although we barely think about it, we swallow about 600 times a day. Would you believe: we swallow even if we don’t eat or drink?

Some people have difficulty swallowing though, either due to physical issues like stroke or Parkinson’s disease or a cognitive problem like dementia or Alzheimer’s disease.

Dr. Barkmeier-Kraemer treats dysphagia, a swallowing disorder. She defines dysphagia as the “impaired” preparation of food after it is placed in the mouth prior to swallowing, or impaired clearance of food from the mouth and throat into the esophagus, where it travels to the stomach. “A breakdown anywhere within that process is called dysphagia.”

Dysphagia is a serious health problem: it causes undernourishment (too little food) and dehydration (too little liquid). In extreme cases, feeding tubes may be used when patients severely lose weight or become dehydrated and malnourished.

One major issue is aspiration pneumonia which affects 2 in 10 patients with dysphagia. It is caused by bacteria in the mouth.

Aspiration pneumonia is a complication of pulmonary or lung aspiration. This happens when food, liquid such as stomach acid, mucus or saliva or even medicine is breathed into the lungs. (Aspiration also occurs when food backs up from the stomach to the esophagus.)

It can cause choking or aspiration pneumonia, a serious lung infection that may spread to other parts of the body such as the bloodstream, which then makes it particularly dangerous.

“We work on good oral hygiene if a patient is prone to aspiration,” says Dr. Barkmeier-Kraemer, pointing out that bacteria in the oral cavity promote aspiration pneumonia.

“The dentists have it right. If you don’t have good oral hygiene, the rest of your body gets sick,” she says.

For dysphagia issues, good oral hygiene is determined during assessments of swallowing conducted by speech-language pathologists.

According to the University of Utah website, assessments start by determining where the problem occurs. Does food get stuck in the throat or chest? Are certain foods the cause? How often is a choke or cough associated with eating? Once these are determined, a treatment plan follows.

This involves dietary modifications, swallowing strategies, changes in physical positioning when swallowing and skills-building exercises. In most cases, patients regain some, if not all, swallowing function.

“I’m very proud to say that our team often takes individuals who arrive at our clinic not able to swallow and we usually get them eating orally within a short duration of time,” Dr. Barkmeier-Kraemer says. “Getting into the hands of experts trained in assessment and treatment of dysphagia is really important so that you can get proper assessment and a successful treatment plan.”/WDJ



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