Dysphagia & Swallowing Disorders in children
Children dysphagia: How dangerous can it be?
Any objective or subjective difficulty in swallowing solid or liquid foods or the appearance of coughing or choking when swallowing is called dysphagia. Especially in children, it involves a particular pathology and it may be accompanied by various symptoms that may be different from one child to the other. It is a very serious symptom that should be treated promptly to avoid serious complications, mainly due to obscure aspirations or respiratory infections, while there are also additional risks for children as regards their physical and psychosocial development.
Children dysphagia is mainly associated with congenital and anatomical abnormalities and developmental problems. It is very likely to occur in premature and underweight babies. It can also occur in children with a history of intubation or feeding catheter for a period of time, and in very rare cases it may be associated with very poor oral hygiene.
It is accompanied by symptoms such as difficulty in breastfeeding or bottle nursing, outflow of liquids or food from the mouth or nose, profuse salivation, difficulty in coordinating breathing and swallowing, coughing or choking during feeding, long-lasting meals usually accompanied by irritation or refusal of food, frequent regressions, regurgitation and vomiting, decreased weight gain, difficulty in chewing, “wet” voice and “wet” crying.
The consequences can be many, such as dehydration, malnutrition of the body and failure to meet nutritional needs resulting in overall poor health and lack of weight gain. Food is associated with negative feelings that can accompany the child for a long time, with denial of food even after treatment of the problem. Moreover, the risk of aspiration is very high, since it can cause continuous respiratory infections and even pneumonia or choking. All this leads to poor quality of life that has an impact on the child’s psychology. Bad mood restricts its engaging in activities, even in the process of socialisation.
Therefore, to avoid all these problems, parents who observe these symptoms in their child should immediately visit a specialist ENT physician that will prescribe the appropriate personalised treatment. With a swallowing evaluation taken in cooperation with the specialised speech therapist easily and directly in his practice, perhaps with some imaging tests in some cases he will have a complete view of the problem and will give the parents advice on the proper position during feeding, on the composition of food, and also some techniques to manage the child’s behaviour in cases of food refusal.
Swallowing disorders. What are they and where can they be attributed?
Dysphagia, or else swallowing disorders, are associated with any subjective or objective difficulty in swallowing solid or liquid foods or the appearance of coughing or choking when swallowing. It should not be confused with other eating disorders such as anorexia nervosa, which is purely psychologically derived. It is a very serious symptom that should be treated promptly, to avoid more serious complications for the patient.
Swallowing is a quite complicated process performed by the body that requires coordinating and controlling 50 muscle groups and five cranial nerves, thus a dysphagia problem can occur due to various causes and be demonstrated with different symptoms.
Some of the symptoms typical in dysphagia is the inability to swallow, making a greater effort to chew and swallow, coughing during or after eating or drinking, long-lasting meals, the feeling of a foreign object in the throat, food or liquids escaping from the mouth, voice alteration, loss of appetite and weight due to insufficient feeding, and repeated infections of the respiratory tract. In children and babies it can be exhibited as a difficulty in breastfeeding or meals (long-lasting meals), as a refusal for food or liquid intake, with coughing or choking during feeding, with frequent respiratory infections and failure to gain normal weight.
The usual causes of dysphagia are strokes, chronic neurological conditions and changes in the anatomy of the mouth, pharynx, larynx, neck further to accidents, surgery or radiotherapy. When symptoms of dysphagia occur in children, they may be due to development problems or disorders of the nervous system, or even to the child’s inability to unconsciously complete this process, since this can be frightening or difficult.
Elderly people run the highest risk of swallowing disorders, since the majority of their functions controlled by the central nervous system is in decline, while taking a lot of medication may affect their taste and consequently food intake. The psychological factor is also an important one leading to loss of appetite.
Swallowing disorders: Impacts and management methods
A patient with swallowing disorders runs many risks, mainly that of aspiration. Aspiration pertains to the entry of foreign material or bodies (blood, pus, food) to the respiratory tract, and it may cause from a respiratory infection to pneumonia or even choking. Moreover, eating and drinking is no longer associated with a feeling of pleasure but to that of pain and discomfort. In addition, the body is malnourished and the patient is dehydrated, undernourished and loses weight. The impact on the patient’s daily life, quality of life and health is manifold.
Dysphagia can be diagnosed using a very specific and affordable examination carried out in the practice, in the hospital or even at home, if the patient cannot be moved. This examination is known as FEES (Flexible endoscopic evaluation of swallowing).
It is very important to have a dysphagia diagnosis, to be able to evaluate with precision, when a patient with these problems can take food by mouth safely, without fear of aspiration. Also, to be able decide on the type and composition of food and the way of feeding, to monitor his course of recovery and to design our treatment strategy. Dysphagia is a very serious problem requiring immediate attention, as it can lead from malnutrition to death in cases of airway obstruction due to aspiration. An ENT specialist will evaluate the nature of the problem and guide the patient to receiving the proper treatment.
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