Treatments for dysphagia are set against the two general types of the disorder. We will see them below and discuss what can be done.
There is almost always a need for strict medical therapies and even surgeries, but it is worth emphasizing that an accurate diagnosis is key to act on. Sometimes there are temporary and banal dysphagias, while other times there is a serious problem, even of an oncological type.
What is dysphagia, and what are its types?
Dysphagia is stipulated as difficulty swallowing. It is not the impossibility of doing it or the pain when something passes down the throat. That can confuse because of the similarity.
If the problem is the throat itself, with pain, it is possible that we are facing odynophagia, mostly infectious or inflammatory causes. At the other extreme, dysphagia exists when the person feels that it is difficult to swallow food or saliva from the oral cavity to the stomach.
As we see by definition, there are several organs involved in the disorder, which makes it more complex. Also, it can be a difficulty for liquids or solids. Those small symptoms guide the diagnosis to a great extent.
The types of clinical presentation are as follows:
- Oropharyngeal: This dysphagia is the classic problem to swallow liquids and food at a high level. It is located in the throat, and its most common causes are neurological. Stroke patients suffer from it, and their eating is complicated, leading to other complications, such as dehydration and weight loss.
- Esophageal: as its name implies, it is dysphagia in the esophagus, lower than the previous one, present for liquids and solids. The esophagus is a hollow and tubular organ, which favors obstruction in neoplastic processes. The most serious cause, of course, is cancer.
Treatments for oropharyngeal dysphagia
To begin with, treatments for oropharyngeal dysphagia require suspicion on the part of the professional who intervenes. The first thing that is suspected are causes that can be corrected with modification of habits since there are solvable problems in these aspects.
One of the first things that are suggested is changes in diet, such as modifying the textures and volumes of food. The intention is to help the patient digest calmly and overcome the upper obstacle of their digestive tract.
In people with neurological disorders due to primary pathologies or sequelae, posture is a determining factor. For many, just changing the position of the neck when eating is enough to correct dysphagia and put it in the past.
Rehabilitation processes are also applied for this activity of daily life. Eating is an apprenticeship when we are little, and it is again in patients with strokes, for example. Both nutritionists and physical therapists teach people to digest.
The use of accessory nutritional support is reserved for complex cases. If the patient does not eat, despite the modifications, or loses weight and becomes dehydrated, then they are indicated.
- The usual mode of help is the nasogastric tube.
- The surgical variant is less frequent, but it is still an option when there is a greater risk in starvation than in inaction.
How is esophageal dysphagia treated?
Esophageal cancer is not the only cause of this dysphagia, so the correct treatment depends on the correct diagnosis. Perhaps there is esophagitis, which is the inflammation of the organ, or achalasia, which is the alteration of the peristaltic movement.
When the approach is surgical, the route of choice is endoscopy. A flexible fiber tube is inserted that runs through the upper digestive system looking for obstructions. The device has a camera at its end and working tools for the surgeon. If there is a foreign body, it is removed, and if a sample must be taken, it is also possible to do so.
In people with severe obstructions due to a decrease in the lumen of the organ, the endoscope can also perform dilations in the same maneuver by correcting the lack of progression of the elements within.
Among the drugs to address the problem without surgery are the following:
- Calcium channel blockers: These drugs claim to regulate muscle contractions of the smooth muscle of the esophagus. Clinical trials dispute its effectiveness.
- Proton pump inhibitors: use is more as adjuvants than direct therapeutics. They reduce the production of hydrochloric acid in the stomach, reducing its reflux, with consequent esophageal irritation.
- Botulinum toxin: Injection of this substance has experimented a few times, but the results are not entirely promising. In the first instance, the application must be repeated every 6 months to maintain the effect, and secondly, the benefited patients received the combination of surgery.
Treatments for dysphagia are complex
As we have seen, it is not easy to address dysphagia and solve it. Serious underlying causes, such as cancer, require an accurate diagnosis that leaves nothing to chance.
Therefore, it is important that consultations are made on time and that the therapeutic indications are respected. The consequences of the disorder are malnutrition and dehydration.