This is a common medical condition that can have implications for the SLP due to potential aspiration and pain related to nutritional intake _(a)_______________________.  What happens if a person has this condition? _(b)______________________________.

A) Dysphagia

B) This is a condition wherein individuals have a difficulty with the swallowing process. This may be due to pain, obstruction or neuromuscular disturbances. Patients may present with coughing or choking when swallowing, difficulty initiating the swallowing process, sialorrhea, vocal changes, or a sensation of food stuck in the throat. This condition may lead to aspiration pneumonia, weight loss due to malnutrition, dehydration and airway obstruction.

Step-by-step explanation

Dysphagia is a common condition in the general population, estimated to have a prevalence of between 16 and 22%. Gastroesophageal reflux disease is the most common cause for dysphagia. Other causes include odynophagia (pain upon swallowing), obstruction due to cancer or benign tumor growths around the oropharynx and esophagus, or neuromuscular disturbances such as stroke, multiple sclerosis, or achalasia.

Patients may present with coughing or choking when swallowing, difficulty initiating the swallowing process, sialorrhea (drooling or excessive salivation), vocal changes typically described as a wet voice, or a globus sensation or sensation of food stuck in the throat. Dysphagia may then result in complications such as recurrent aspiration pneumonia, weight loss due to malnutrition due to changes in dietary habits, dehydration and airway obstruction.

Diagnosis of this condition starts with a thorough history-taking and physical examination. Additional diagnostic tests include esophagoscopy, auscultation of the cervical area, blood tests including thyroid-stimulating hormone and creatine kinase, imaging studies including CT-scan and MRI and chest x-ray (for suspected cases of pneumonia), and endoscopic examination.

Treatment includes pharmacologic, dietary and rehabilitative management. Medications to be given include botulinum, diltiazem, or others that target the specific disease process causing dysphagia. Dietary modification is also encouraged, where patients are classified according to the type of food they are able to consume. Rehabilitation include exercises to strengthen swallowing muscles, and facilitation techniques such as deep pharyngeal neuromuscular stimulation.