Evaluation and Treatment for Swallowing Disorders

Swallowing disorders, also called dysphagia, can cause difficulty or pain during swallowing. Or you may feel that food or liquid is stuck in your throat or anywhere else before entering the stomach.

Sutter teams use a multidisciplinary approach to diagnose and treat swallowing disorders. Laryngology and speech pathology specialists will provide you with a comprehensive evaluation of swallowing function during your first visit. Once you’re diagnosed, we’ll work with you to design an individualized treatment plan that may include medical and surgical options provided by a laryngologist and behavioral interventions provided by speech language pathologists (SLPs).

The most common causes of swallowing problems include:

Head and neck cancer
Stroke
Head trauma
Tracheostomy or being on a ventilator
Cerebral palsy
Parkinson’s disease
Multiple sclerosis
Spinal cord injury
Amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease)
Myasthenia gravis
Gastroesophageal reflux disease (GERD)
Laryngopharyngeal reflux disease (LPRD)
Muscle tension dysphagia
Zenker’s diverticulum

Laryngologists and SLPs specialize in evaluating and treating symptoms of swallowing disorders, including:

Drooling.
Food or liquid remaining in the mouth after swallowing.
Difficulty maintaining lip closure.
Food or liquids leaking from the nasal cavity.
Feeling of food sticking in throat.
Pain when swallowing.
Wet or gurgling voice during or after eating or drinking.
Coughing during or right after eating or drinking.
Difficulty coordinating breathing and swallowing.
Taking extra effort or time to chew or swallow.

To identify swallowing problems, laryngology and speech pathology specialists use a variety of tests, such as:

Clinical Swallowing Evaluation (CSE) — The laryngologist and SLP will examine your mouth structures and function, ask questions about your medical history and ability to swallow, and may evaluate you as you eat different foods or liquids.
Flexible Endoscopic Evaluation of Swallowing (FEES) — The laryngologist and SLP will use a lighted fiberoptic tube (endoscope) to view your mouth and throat while examining how your swallowing mechanism responds to different types of foods or liquids.
Videofluoroscopic Swallow Study (VFSS) or Modified Barium Swallow Study (MBSS) — The SLP and a radiologist will take a videotaped X-ray of the entire swallowing process by having you eat different foods or liquids along with the mineral barium.

Swallowing Rehabilitation Services

We also offer swallowing rehab services to help you improve overall function and achieve a safer and more efficient swallow:

Exercises to strengthen specific muscle groups.
Safe swallowing strategies and techniques to improve swallowing efficiency and reduce the risk of aspirating (breathing in) food and liquids.
Modification of food textures to prevent choking and reduce aspiration risk.
Comprehensive patient and family education to help understand the reasons and goals for swallowing rehabilitation.
McNeill Dysphagia Therapy Program (MDTP), a systematic, intensive swallowing rehabilitation program that uses exercise-based swallowing training.
Respiratory Muscle Strength Training (RMST), an effective and intensive muscle training program to strengthen the dysfunctional swallow muscles.
Myofascial release, a manual therapy provided by SLPs to help improve range of motion, chewing ability and ease of swallowing.
Surface EMG Biofeedback (sEMG), a device that displays the activity of your swallowing muscles to help you learn new and unfamiliar swallowing exercises.