Dysphagia may be caused by certain medical conditions, including: 

• Stroke 

• Traumatic brain injury 

• Radiation exposure secondary to cancer of the tongue or larynx

• Neurological diseases, such as Parkinson's disease or amyotrophic lateral sclerosis (ALS) 

• Age-related changes in older adults  

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Signs and symptoms associated with dysphagia can include:

• Drooling 

• Difficulty chewing 

• Prolonged mealtimes 

• Inability or difficulty when trying to swallow

• Pain when swallowing 

• A sensation of food getting stuck in the throat or chest or behind the breastbone (sternum)

• Coughing

• Frequent throat clearing

• Change in voice quality after eating and drinking (e.g., Hoarseness)

• Frequent heartburn 

• Food or stomach acid backing up into the throat

• Unintentional weight loss

 

Swallowing Evaluation 

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At sfs therapies we employ a progressive process of swallowing evaluations to determine which procedure is best suited for each of our patients. 

 

Clinical Swallowing Evaluation

 

The SLP will perform a clinical (bedside) swallow evaluation. They will ask you questions about your difficulties with swallowing and assess the strength and movement of your jaw, lips and tongue. During the clinical swallow evaluation, you will be asked to consume a variety of foods and liquids while the SLP watches and makes note of any outward signs or symptoms of dysphagia (swallowing difficulty). This study allows our SLP the information needed to determine if an objective measure procedure is medically necessary and which procedure is most appropriate. If such a procedure is medically necessary, it may include one or both of the following evaluations:

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• Modified barium swallow study (MBSS). During the MBSS, you will be asked by the SLP to swallow small portions of different consistencies of foods/liquids containing a small amount of barium. Both the SLP and a radiologist will watch via imaging as the barium passes through your throat, documenting any variation from normal swallowing. Modified Barium Swallow Studies are performed offsite in a variety of settings, including outpatient imaging facilities such as Desert Radiology, Steinberg Diagnostics or Simon med.

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• Flexible Endoscopic evaluation of swallowing (FEES). A narrow scope is passed into your throat through the nose so the clinician may observe what is happening in the throat while you swallow foods and liquids. FEES are performed in our clinic or through our mobile services at a skilled nursing facility, long term care facility, hospital and or physicians' office.

 

Mobile FEES and Modified Barium Swallow Studies are performed offsite in a variety of settings, including Outpatient Imaging facilities and Physicians' offices.

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Swallowing Therapy

 

The SLP develops a plan of care (POC) after viewing either one of the instrumental studies. Your plan of care may include: 

• Modification of diet textures and consistencies (in accordance with the International Dysphagia Standardization Initiative (IDDSI)) 

• Compensatory strategies to improve swallowing ease and safety 

• Swallowing exercises to improve swallow

  • At sfs therapies, our SLPs are trained to provide the McNeil Dysphagia Therapy Program (MDTP). MDTP is a systematic exercise therapy program for dysphagia in adults. Using the swallow as exercise, MDTP systematically organizes swallowing activities using exercise physiology principles.

• Patient and caregiver education and training on the anatomy of swallowing and adherence of the home plan of care with the recommended IDDSI diet consistencies, compensatory strategies, and exercises. 

  

During therapy, depending on the results of the study: 

• You will learn exercises designed to improve the movement and strength of the muscles involved in swallowing.  

• You will learn compensatory strategies and techniques to improve the safety of swallowing during meals.  

• You will learn about the food textures and liquid consistencies in accordance with IDDSI that are most appropriate for you based upon the instrumental study. 

• You will be empowered with a personalized "in home" program to continue the recommended plan of care between therapy sessions.

  

The goal of sfs therapies is to give you the means to achieve a safe swallow that supports your nutritional and hydration needs while allowing you to enjoy the widest variety of food textures and liquid consistencies possible.