difficulty in SWALLOWING; also known as APHAGIA.
Dysphagia can seriously compromise nutritional status. Measures such as texture modified diet and fluids and tube feeding can help manage the immediate problem, but do not treat the underlying cause.
Neurological oropharyngeal dysphagia is a difficulty in the oral or pharyngeal phases of swallowing, caused by several neurological conditions such as stroke.
There are numerous underlying causes, including stroke and other neurological conditions, local trauma and muscle damage, a tumour or swelling that partially obstructs the passage of food. The condition can range from mild discomfort, to a severe inability to control the muscles needed for chewing and swallowing.
Phagenyx has been designed to treat those patients suffering from neurological dysphagia, the inability to control swallowing. Neurological dysphagia can occur for a number of reasons although is often caused by damage to the nerves that control the muscles of swallowing. One of the most common causes of this nerve damage is a stroke.
Depending on which research information you refer to, between 30 and 78% of stroke patients have dysphagia during the first few days or weeks after their stroke and between 40 to 81% of adult stroke patients have dysphagia when entering the rehabilitative phase of their recovery read more. For some, the dysphagia will persist for the rest of their lives.
Incidence of dysphagia ranges from 3 to 62% of critically ill (ICU endotracheal intubation) patients read more, a recent trial showing positive dysphagia screening in 12.4% (n=116/933) patients after extubation (18.3% of emergency and 4.9% of elective patients) read more. Furthermore, dysphagia is common among tracheotomized patients (50-83%) read more.
Dysphagia causes people to have difficulties when they are eating or drinking. These difficulties may cause coughing or choking as food or drink gets stuck in the throat or ‘goes down the wrong way’ into the lungs rather than into the stomach.
The medical term for the passing of food or drink into the lungs is ‘aspiration’. It is common for people with dysphagia to experience recurrent chest infections related to the drink or food particles that have entered into their lungs and then caused an infection. This can progress to a more serious complication called aspiration pneumonia that often requires a prolonged hospital stay and may even be fatal.
When dysphagia remains untreated, a variety of complications can occur read more. In addition to recurrent chest infections and aspiration pneumonia read more, research studies have also shown that patients who are experiencing dysphagia as a result of stroke are likely to spend longer time in the hospital than stroke patients who don’t have dysphagia read more. They are also more likely to be discharged to a 24 hour care setting (such as a nursing home) read more. And further more, they can have 3 times higher mortality risk read more and 7 times higher morbidity risk read more.
Other studies have shown that patients who have dysphagia are more likely to develop malnutrition. In addition, people with dysphagia often have strict limitations in the texture and/or quantity of food and drink they are able to swallow safely. Others are not able to swallow any food or drinks safely and so require feeding via a tube, either in the short or longer term. This can impact on the pleasures and social opportunities of mealtimes read more and lead to feelings of isolation, loss of dignity, anxiety and depression read more.
Complications associated with dysphagia significantly increase healthcare costs due to the increased length of stay in hospital read more:
- Treatment of aspiration pneumonia read more
- Placement of feeding tubes read more
- Assessment of swallow function read more
- Need to support patients at mealtimes, providing texture modified food and/or drinks read more
Increased costs are also associated with care provided by a 24 hour nursing care facility, which those with dysphagia are more likely to require read more.
Previous research has shown that if the areas of the brain responsible for swallowing control and coordination become damaged, it can result in a swallowing disorder read more.
When people do manage to recover their ability to swallow, it is usually because another, undamaged part of the brain, has taken over responsibility for swallowing control read more.
Not everyone recovers their swallow function after a stroke and, even for those who do, the length of time the natural recovery process takes can vary considerably, putting the patient at risk of complications during this time.
In addition, it is not possible to predict from the outset who will or won’t recover from a swallowing disorder after a stroke or how long this recovery process might take.