Types of dysphagia

There are two types of dysphagia:

  • swallowing difficulties caused by problems with the mouth or throat (oropharyngeal or high dysphagia)
  • swallowing difficulties caused by problems with the oesophagus (oesophageal or low dysphagia)

In young patients, oropharyngeal dysphagia is most commonly caused by muscle diseases27. In older people however, neurological conditions such as stroke, dementia and Parkinson’s disease are the major cause of oropharyngeal dysphagia (75% of cases)10.

Studies suggest that within 3 days of a stroke, 42–67% of patients present with oropharyngeal dysphagia—making stroke the leading cause of dysphagia. The severity of the dysphagia tends to be associated with the severity of the stroke27.

Dysphagia resulting from stroke is temporary in 90% of cases, whereas in patients with dementia or Parkinsonian syndromes it is usually part of a general decline11. Up to 50% of Parkinson patients show some symptoms consistent with oropharyngeal dysphagia27.

Oesophageal dysphagia typically occurs as a result of an obstructive disorder.

Signs and symptoms of dysphagia9

  • History of choking
  • Cough before, during or after the swallow
  • History of chest infections
  • Change in breathing pattern or shortness of breath when eating / drinking
  • Wet, bubbly voice quality
  • Weight loss
  • Prolonged mealtimes
  • Refusal to eat / drink
  • Regurgitation

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  • Dysphagia - NHS choices
  • Dysphagia - Patient.co.uk
  • Swallowingdifficulties.com
  • Ensuring safer practice for adults with learning disabilities who have dysphagia - NSPA
  • Free online course - Swallowing difficulties and medicines. University of East Anglia and Future Learn.
  • Steps to Understanding Dysphagia in Adults with Learning Disability – RCGP accredited educational webcast
  • Dysphagia Global Guidelines - World Gastroenterology Organisation.