b'Symptom ManagementDysphagia and MS Dysphagia and MS The overt and subtle symptoms The overt and subtle symptoms of swallowing dysfunction.of swallowing dysfunction.By Marissa A. Barrera, PhD, MSCS, CCC-SLP and Barbara OConnor-Wells, PhD, MSCS, CCC-SLPYou may have heard the term dysphagiaMS population has swallowing difficulties. (pronounceddis-fay-ja)fromphysicians,Furthermore, researchers identified a link nurses, speech-language pathologists, andbetween dysphagia and brainstem lesion other medical staff. Dysphagia is the clinicalloadnoting a prevalence of 34 percent of MS term for impaired, or abnormal, swallowing.participants. The root dys refers to disorder or abnormality,On average, adults swallow approximately and the suffix, phagia, arises from the Greek1,000 times daily. For most individuals, word phagos which means to swallow.swallowing is easy and largely unconscious, but Dysphagia refers to abnormalities in theswallowing is a complex, highly coordinated transportation of food or liquids from theneurological process. Impaired swallowing mouth to the stomach. function in people with MS is because of the According to the National Foundation ofcoexistence of several factors including:Swallowing Disorders, there are between Lesions in corticobulbar tracts 300,000and600,000newlydiagnosed Paresis of the cranial nervesindividuals with dysphagia each year in the Disorders of the cerebellum and brainstem United States. Because of advances in medical technology, pharmacology, and increases in life Insufficient sensory feedback expectancy, the risk of developing dysphagia Disruption of air-lowis steadily increasing. Muscle atrophy because of disuse Dysphagia is not a disease, but rather a Poor positioning symptom of an underlying disease. Difficulty Kyphosis swallowing is caused by something else, such as Cognitive dysfunction a stroke, traumatic brain injury, or degenerative diseasessuch as Parkinsons disease,Signs and symptoms of dysphagia may amyotrophic lateral sclerosis, or multiplebe obvious, such as: sclerosis. Although it is not typically the rst Coughing, choking, or gagging on food sign of MS, dysphagia is observed in mildlyor liquid impaired patients with lower scores on the The sensation of food or liquid going down Expanded Disability Status Scale. The prevalencethe wrong pipe of dysphagia increases as the disease progresses, Regurgitationorreuxoffoodorliquid reaching as high as 65 percent. One analysis(coming back up into the throat) determined there is an estimated dysphagia prevalence of 36 percent in people with MS, Pain when swallowing (odynophagia) concluding that approximately one-third of the Feeling food or liquid gets stuck msfocusmagazine.org 16'