How is dysphagia treated?

Updated: Mar 20, 2020
  • Author: Nam-Jong Paik, MD, PhD; Chief Editor: Elizabeth A Moberg-Wolff, MD  more...
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The goals of dysphagia treatment are to maintain adequate nutritional intake for the patient and to maximize airway protection.

Disorders of oral and pharyngeal swallowing are usually amenable to rehabilitation, including dietary modification and training in swallowing techniques and maneuvers. [1] Surgery is rarely indicated for patients with swallowing disorders, although in patients with severe disorders, bypassing the oral cavity and pharynx in their entirety and providing enteral nutrition may be necessary. Options include percutaneous endoscopic gastrostomy and intermittent oroesophageal catheterization.

Various treatments have been suggested for the treatment of oropharyngeal dysphagia in adults. Direct and indirect strategies for treating dysphagia have been described. Direct strategy usually refers to treatment that involves food, whereas indirect strategy refers to an exercise regimen performed without a food bolus. Direct techniques include modifications of food consistency; indirect techniques include stimulation of the oropharyngeal structures and the adoption of behavioral techniques, such as those involving postural changes or the swallow maneuver. [48, 49]

The Dietetics in Physical Medicine and Rehabilitation dietetic practice group conceived the National Dysphagia Diet project in 1996. This group became known as the National Dysphagia Diet Task Force (NDDTF). Growing frustration regarding a lack of standardization for solid-food textures, liquid consistencies, and nomenclature led to the formation of a task force to study the issue and to formulate a new diet based on scientific food properties and clinical swallowing problems. In 2002, the American Dietetic Association established the National Dysphagia Diet (NDD) to provide national guidelines and standardized terminology for texture modification for dysphagia management. The NDD contains suggested viscosity ranges for different types of modified fluids. [50]

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