An elderly friend frequently has spasms of the esophagus (she thinks) while swallowing (trapping food and making it difficult for her to eat much at one time). She does not know what triggers the spasm. Her doctors do not appear to be concerned but I would like to refer her to have this checked out. What is her best course of action?
Answer
Your elderly friend should schedule an appointment with her physician. Her description of her swallowing problem is probably pretty accurate. Most of the time, the patient is able to pinpoint the source of the problem based on sensations during the swallowing process.
The swallowing process involves three phases: the oral phase, the pharyngeal phase and the esophageal phase. It is possible that your elderly friend is having difficulty in either of the latter two phases, most likely the esophageal phase. Several medical tests can determine the exact cause of the problem. Based on her description of where she feels the food is being trapped, her physician can order a modified barium swallow, which will look at primarily the first two phases of the swallow or a standard barium swallow, which primarily looks at the esophageal phase through to the stomach. Other medical tests may also be indicated allowing a more direct visualization of the GI tract.
Narrowing of the esophagus can be related to esophageal stricture (narrowing), diverticuli (pockets) in the esophagus, or hiatal hernia. Only a close examination by a physician and appropriate medical testing will reveal the true source of the problem. Once the source is identified, proper treatment should alleviate her symptoms.
Kathy Thayer, MA
Kathy Thayer received her Master of Arts in Health Services Management from Webster University and a Certificate in Gerontology and a Master of Arts in Communication Disorders from Saint Louis University. Kathy has worked for several years as a Speech-Language Pathologist and is currently employed by Rehab Works in Sparks, Maryland.
Related Courses
1https://www.speechpathology.com/slp-ceus/course/ethical-considerations-when-working-with-8991Ethical Considerations When Working with Those who StutterThis course will discuss how the stigma of stuttering, advocacy, empathy, caseload management, and the structure of various settings in which we work (e.g., schools, medical settings, university clinics) impact our work with people who stutter, across the lifespan. Case scenarios involving ethics and stuttering will be presented for participants' consideration.auditory, textual, visual
This course will discuss how the stigma of stuttering, advocacy, empathy, caseload management, and the structure of various settings in which we work (e.g., schools, medical settings, university clinics) impact our work with people who stutter, across the lifespan. Case scenarios involving ethics and stuttering will be presented for participants' consideration.
2https://www.speechpathology.com/slp-ceus/course/motor-speech-components-stuttering-clinical-10537Motor Speech Components of Stuttering: Clinical Applications Across the LifespanAspects of motor speech include timing, sensory-motor integration, and motoric divergence that are inherited. This course discusses the motor speech components of stuttering. Planning assessment and treatment with preschoolers, school-aged children, teens and adults based on motor speech components is also described.auditory, textual, visual
Aspects of motor speech include timing, sensory-motor integration, and motoric divergence that are inherited. This course discusses the motor speech components of stuttering. Planning assessment and treatment with preschoolers, school-aged children, teens and adults based on motor speech components is also described.
3https://www.speechpathology.com/slp-ceus/course/thickened-liquids-in-clinical-practice-10497Thickened Liquids in Clinical Practice: The Plot “Thickens”Clinicians who utilize thickened liquids in their clinical practice are aware of their benefits, but what about the risks and contraindications? Advantages and disadvantages of thickened liquids are reviewed in this course with a focus on clinical outcomes, including impacts on medication administration, lung health, and hydration. Product types are evaluated to facilitate appropriate choices for individual clients.auditory, textual, visual
Clinicians who utilize thickened liquids in their clinical practice are aware of their benefits, but what about the risks and contraindications? Advantages and disadvantages of thickened liquids are reviewed in this course with a focus on clinical outcomes, including impacts on medication administration, lung health, and hydration. Product types are evaluated to facilitate appropriate choices for individual clients.
4https://www.speechpathology.com/slp-ceus/course/dysphagia-in-neurodegenerative-disease-9732Dysphagia in Neurodegenerative DiseaseDysphagia is common in individuals with amyotrophic lateral sclerosis (ALS) and Parkinson’s disease. This course discusses the underlying pathophysiology and appropriate treatment programs for each disease, as well as use of alternate methods of nutrition/hydration.auditory, textual, visual
Dysphagia is common in individuals with amyotrophic lateral sclerosis (ALS) and Parkinson’s disease. This course discusses the underlying pathophysiology and appropriate treatment programs for each disease, as well as use of alternate methods of nutrition/hydration.
5https://www.speechpathology.com/slp-ceus/course/20q-in-thick-it-international-1075620Q: In the Thick of It - The International Dysphagia Diet Standardization Initiative (IDDSI)The importance of using IDSSI to provide standardized language when speaking about texture modification is discussed in this course. Comparisons of IDDSI and the National Dysphagia Diet (NDD), as well as IDDSI standards for pediatric vs. adult patients are presented. Additionally, potential barriers, solutions, and frequently asked questions related to implementation of IDDSI are described.textual, visual
The importance of using IDSSI to provide standardized language when speaking about texture modification is discussed in this course. Comparisons of IDDSI and the National Dysphagia Diet (NDD), as well as IDDSI standards for pediatric vs. adult patients are presented. Additionally, potential barriers, solutions, and frequently asked questions related to implementation of IDDSI are described.
