There are different treatments for various types of dysphagia. Medical doctors and speech-language pathologists who evaluate and treat swallowing disorders use a variety of tests that allow them to look at the stages of the swallowing process. One test, the Flexible Endoscopic Evaluation of Swallowing with Sensory Testing (FEESST), uses a lighted fiberoptic tube, or endoscope, to view the mouth and throat while examining how the swallowing mechanism responds to such stimuli as a puff of air, food, or liquids.
A videofluoroscopic swallow study (VFSS) is a test in which a clinician takes a videotaped X-ray of the entire swallowing process by having a patient consume several foods or liquids along with the mineral barium to improve visibility of the digestive tract. Such images help identify where in the swallowing process the patient is experiencing problems. Speech-language pathologists use this method to explore what changes can be made to offer a patient a safe strategy when swallowing. The changes may be in food texture, size, head and neck posture, or behavioral maneuvers, such as “chin tuck,” a strategy in which a patient tucks her chin so that food and other substances do not enter the trachea when swallowing. If a patient is unable to swallow safely despite rehabilitation strategies, then medical or surgical intervention may be necessary for the short-term as the patient recovers. In progressive conditions such as amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease), a feeding tube in the stomach may be necessary for the long-term.
For some people, treatment may involve muscle exercises to strengthen weak facial muscles or to improve coordination. For others, treatment may involve learning to eat in a special way. For example, some people may have to eat with their head turned to one side or looking straight ahead. Preparing food in a certain way or avoiding certain foods may help in some situations. For instance, people who cannot swallow thin liquids may need to add special thickeners to their drinks. Other people may have to avoid hot or cold foods or drinks.
For some, however, consuming enough foods and liquids by mouth may no longer be possible. These individuals must use other methods to nourish their bodies. Usually this involves a feeding system, such as a feeding tube, that bypasses or supplements the part of the swallowing mechanism that is not working normally.