Evaluation and treatment of swallowing impairments

Jeffrey B. Palmer, Jennifer C. Drennan, Mikoto Baba

Research output: Contribution to journalArticle

Abstract

Swallowing disorders are common, especially in the elderly, and may cause dehydration, weight loss, aspiration pneumonia and airway obstruction. These disorders may affect the oral preparatory, oral propulsive, pharyngeal and/or esophageal phases of swallowing. Impaired swallowing, or dysphagia, may occur because of a wide variety of structural or functional conditions, including stroke, cancer, neurologic disease and gastroesophageal reflux disease. A thorough history and a careful physical examination are important in the diagnosis and treatment of swallowing disorders. The physical examination should include the neck, mouth, oropharynx and larynx, and a neurologic examination should also be performed. Supplemental studies are usually required. A videofluorographic swallowing study is particularly useful for identifying the pathophysiology of a swallowing disorder and for empirically testing therapeutic and compensatory techniques. Manometry and endoscopy may also be necessary. Disorders of oral and pharyngeal swallowing are usually amenable to rehabilitative measures, which may include dietary modification and training in specific swallowing techniques. Surgery is rarely indicated. In patients with severe disorders, it may be necessary to bypass the oral cavity and pharynx entirely and provide enteral or parenteral nutrition.

Original languageEnglish (US)
Pages (from-to)2453-2462
Number of pages10
JournalAmerican Family Physician
Volume61
Issue number8
StatePublished - Apr 15 2000

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Deglutition
Deglutition Disorders
Physical Examination
Mouth
Diet Therapy
Therapeutics
Aspiration Pneumonia
Oropharynx
Parenteral Nutrition
Manometry
Neurologic Examination
Enteral Nutrition
Airway Obstruction
Larynx
Gastroesophageal Reflux
Pharynx
Nervous System Diseases
Dehydration
Endoscopy
Weight Loss

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Palmer, J. B., Drennan, J. C., & Baba, M. (2000). Evaluation and treatment of swallowing impairments. American Family Physician, 61(8), 2453-2462.

Evaluation and treatment of swallowing impairments. / Palmer, Jeffrey B.; Drennan, Jennifer C.; Baba, Mikoto.

In: American Family Physician, Vol. 61, No. 8, 15.04.2000, p. 2453-2462.

Research output: Contribution to journalArticle

Palmer, JB, Drennan, JC & Baba, M 2000, 'Evaluation and treatment of swallowing impairments', American Family Physician, vol. 61, no. 8, pp. 2453-2462.
Palmer JB, Drennan JC, Baba M. Evaluation and treatment of swallowing impairments. American Family Physician. 2000 Apr 15;61(8):2453-2462.
Palmer, Jeffrey B. ; Drennan, Jennifer C. ; Baba, Mikoto. / Evaluation and treatment of swallowing impairments. In: American Family Physician. 2000 ; Vol. 61, No. 8. pp. 2453-2462.
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