Treatment Approaches and Principles for Patients with Dysphagia

Swallowing is a complex process involving a set of physiologic behaviors which result in food, liquid, or other substances moving safely and efficiently from the mouth to the stomach. Patients with dysphagia may have difficulty with any one or more of the anatomic or physiologic components of the oral, pharyngeal, or esophageal stages of the swallow. Early diagnosis and effective management of dysphagia can reduce the incidence of pneumonia and improve quality of care and outcome. The goals of dysphagia treatment are to maintain adequate nutritional intake for the patient and to maximize airway protection. This presentation aims to focus on the treatment approaches and principles for oropharyngeal dysphagia in adults. Direct and indirect strategies for treating dysphagia will be described. Various treatments include stimulation of the oropharyngeal structures and the adoption of behavioral techniques, such as postural changes or the swallow manoeuver, or enhancing sensory input, or active muscle exercise with or without the introduction of food, and modifications of food consistency. The importance of carers in taking responsibility for following the safe swallow recommendations made by the Speech-Language Pathologist (SLP) will also be highlighted.