Taran Tatla
Honorary Secretary, ENT UK
In health, eating and drinking play an important role for physical, social and mental well-being.
Definitions of dysphagia vary, making it difficult to quantify its prevalence and incidence or illustrate its impact on society. At an elemental level, it is swallowing difficulty for liquids, solids or both. It can be short-lived, intermittent or progressive in nature.
In severe cases, malnutrition and weight loss may raise alarm, particularly through worry of cancer. However, more commonly it links with other factors such as taste or appetite disturbance, cognitive disturbance and food allergies (known or unknown).
Anxiety and stress frequently link with swallowing difficulty, highlighting a complex and intricate link between mental and gut health.
Dysphagia affects all ages
Swallowing disturbance is common, conservative estimates suggest 8% of the world population and almost 100 million in the developed world are impacted.
All ages can be affected, although it appears more commonly at the extremes of age. Later age-related swallowing difficulty is increasingly recognised with an ageing UK population, difficulties compounded when conditions such as Alzheimer’s and Parkinson’s co-exist.
Swallowing disturbance is common, conservative estimates suggest 8% of the world population and almost 100 million in the developed world are impacted.
Symptoms are managed by multiple healthcare professionals in specialist, community and nursing home settings. Primary presentation may be through onset of seemingly unrelated symptoms, including voice change, coughing or choking.
Systematic enquiry, examination and investigations require coordinated expertise crossing traditional in-hospital and community care boundaries.
Better education for all
During COVID-19, usual patterns for healthcare working and service delivery have been disturbed. Patients at extremes of age, already highly vulnerable for dysphagia, have been impacted in even greater measure through delays in referral, investigation and treatment pathways.
Better public and health professional education is critically needed. In later years, dysphagia may be fixed simply through provision of well-fitted dentures, or assisting loved ones with shopping, cooking and feeding at mealtimes.
For more complicated scenarios, recognition of the “at risk” individual, when, how and who to call upon for help and prompt support is key; the development of integrated care pathways for dysphagia hold much promise.
World Voice Day highlights the need for greater public and professional awareness of dysphagia, and its impact on quality of life.
