My father had a stroke 3 months ago; he was in hospital for a while but has recovered and is now at home. He said that he is eating and drinking fine but I have noticed that he is coughing a lot when he is drinking. Is this something we should get checked out in case it has been caused by the stroke?
Strokes and other neurological (affecting the brain, nerves or spinal chord) conditions like multiple sclerosis and dementia are common causes of dysphagia. There are many stages to swallowing and it is a very complex process meaning problems can occur at any stage. Dysphagia problems known as ‘low dysphagia’ are often due to narrowing or obstruction to the oesophagus (tube connecting mouth to stomach) due to conditions such as cancer. However, a stroke can affect the nerves responsible for triggering/starting or controlling a swallow, which causes ‘high dysphagia’. If this is the case then food can fall down the trachea (windpipe) during eating and drinking. This can cause the patient to cough frequently as the body tries to clear the food and prevent it getting to the lungs.
Dysphagia can be a very serious condition if left untreated. A common complication is recurrent chest infections due to the food getting into the lungs and causing infection. This can develop to aspiration pneumonia, which can cause a lot of suffering and even death in weak or older patients.
Dysphagia can also cause people to become malnourished or dehydrated if they are not managing to eat or drink adequately. Someone’s quality of life is likely to be significantly reduced, they may feel unable to participate in social events involving food and drink and thus may miss special events or become isolated.
Treatment
The symptoms and severity of dysphagia differs a great deal between patients depending on the cause and severity of the dysphagia. A speech and language therapist may suggest swallowing therapy to improve swallowing or to make it safer. This could include for example changing the head position when you swallow.
A speech and language therapist could also suggest dietary changes. There are particular foods that are ‘high risk’ foods for people with swallowing problems and should be avoided. Changing the consistency of food or drink can make swallowing safer and it may be recommended that drinks need to been thickened which will slow the passage down the throat. In more serious cases tube feeding may be a short or long-term option.
Sometimes dysphagia is not caused by a stroke or other condition. As you get older, muscles become weaker and this is the same in the throat, which can cause dysphagia. It is important to consult your GP if you see any of the following signs in yourself or others:
- Coughing during eating and drinking or shortly after
- Weight loss
- Needing multiple swallows to clear food
- Loss of appetite
- Wet/gurgling voice after drinking
If you would like to discuss this further then here at Integrated Treatment Services we are happy to speak with you over the telephone on: 0845 838 2921 or answer questions by email: info@integratedtreatments.co.uk. Experienced speech and language therapist are able to listen to your concerns, guide you through how to access NHS support and explain what you can be doing whilst you wait to be seen. Alternatively, we could arrange one of our team to come and assess the client within a week or referral.
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