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Dysphagia

Dysphagia is a disorder of swallowing that may manifest itself in the oral, pharyngeal and esophageal phase of your swallow function. It may be a result of a physiological, anatomical or neurological deficit, which would result in your inability to meet nutrition and hydration requirements and negatively impact your health, nutrition and quality of life. Our goal is to evaluate and treat dysphagia so that you can once again enjoy eating and have all of your nutritional needs met.

Tests & Diagnosis

pH acid monitoring is a disposable capsule placed into your esophagus using an endoscope. It wirelessly transmits information about esophageal acid levels to a receiver worn around your waist for 48 hours.

High resolution manometry measures the strength, pressure and coordination of your esophagus' muscles. A specially trained nurse guides a small catheter through your nose and into the esophagus and instructs you to swallow small amounts of liquid at specific intervals.

A 24-hour impedance catheter is used to measure the reflux of fluid and gauge its proximity to your voice box. This test is typically used for patients who are experiencing cough, respiratory or non-classical GERD symptoms. A small catheter is inserted through your nose and records data in receiver worn around your waist during while you conduct your regular daily activities.

Comprehensive swallowing evaluation assesses your oral, pharyngeal and hypopharyngeal swallowing function as you are given various consistencies and textures of food and liquids. Your reflexive swallow function is examined and analyzed for mechanisms of dysfunction. This evaluation is combined with a barium swallow study, which involves you drinking a chalky liquid (barium solution) that coats your esophagus, allowing us to better view all phases of your swallowing on X-rays. 

Endoscopic evaluation of swallowing is when a small endoscope (with light and camera) is passed through your nose and into your throat. We examine the structure and function of your swallow is while giving you various consistencies of food and liquid. This test allows direct visual examination of your swallow function.

Comprehensive nutritional assessment is an evaluation of your nutritional history, using biochemical markers of nutrition status, review of your clinical status and and a nutritionally focused physical exam. Your nutritional needs are analyzed, and we make appropriate recommendations.

Treatments

Dysphagia therapy is for a patient with oral and/or pharyngeal swallowing disorders. It may include an oral motor exercise program and pharyngeal / laryngeal muscle strengthening exercises. The therapy may include training you in strategies to be used when your eating or drinking and specific diet modifications required for the most efficient and safe intake of nutrition while preventing aspiration. VitalStim may be utilized as part of dysphagia therapy, which is the use of neuromuscular stimulation of the swallowing muscles.

Nutritional counseling is used to improve your nutritional status, including healthy weight management, pre- and post-operative diet management (including tube-feeding management) and food allergy management.

Personalized treatment options includes medications, endoscopic swallowing therapy and minimally invasive endoscopic surgery, based on the specific pathology.