Nursing Management for Dysphagia

Dysphagia is a symptom or complaint that caused the abnormalities in the upper gastrointestinal tract, the oropharynx and esophagus.

This problem most often occurs in people who have abnormalities in voluntary muscle (skeletal muscle) or innervation, namely patients:
  • Dermatomyositis (Polymyositis accompanied by inflammation of the skin)
  • Myasthenia gravis (muscle weakness)
  • Muscular dystrophy (muscle disease where the derivative of the muscle fibers are very vulnerable to damage)
  • Polio
  • Pseudobulbar paralysis (paralysis of the eye muscles, difficulty swallowing, emotional instability)
  • Abnormalities of the brain and spinal cord such as Parkinson's disease and amyotrophic lateral sclerosis
  • People who are taking phenothiazines (drugs antipsikosa) may also have difficulty swallowing because the drug affects the throat muscles.

Etiology
  • Mechanical dysphagia, esophageal cavity occurs due to blockage by mass, inflammation, constriction, or pressure from outside.
  • Motor dysphagia, due to abnormalities in the nervous system that play a role in the process of swallowing.
  • Dysphagia due to severe emotional disorders / psychogenic dysphagia
  • Congenital abnormalities (congenital)
  • Trauma
  • Foreign body
  • Degenerative diseases

Symptoms and Signs
  • Difficulty in swallowing.
  • Frequent coughing and gagging.
  • Find it easier to eat slowly.
  • Storing food in the mouth long enough.

Management for Dysphagia

There are different treatments for different types of dysphagia . The first physician and speech - language pathologists who examine and deal with swallowing disorders use a variety of tests that allow to see the various functions of swallowing . One test is called , fiber optic laryngoscopy , which allows the doctor to look inside the throat . Other tests, including video fluoroscopy , which takes video footage of patients in swallowing and ultrasound , which produces the picture of the organs in the body , can be freely demonstrates the stages of pain in swallowing .

Once the cause of dysphagia is found, surgery or medication may be given . If by treating the cause of dysphagia does not help , your doctor may send a patient to hologist pathologist trained in addressing and treating problems swallowing disorders.

Treatment may involve muscle exercises to strengthen facial muscles or to improve coordination. For others, treatment may involve swallowing training in a special way. For example, some people have to eat primarily to position the head turned to one side or looking straight ahead. Prepare such food or avoiding certain foods may help others. For example, those who can not swallow drinks may require special thickeners to drink. Other people may have to avoid foods or beverages hot or cold.

For some people, however, consume food and drink by mouth is not possible anymore. They must use other methods to meet the nutritional needs. This usually requires a feeding system, such as a feeding tube (NGT), which cut the swallow who are unable to work normally.

Various treatments have been proposed for the treatment of oropharyngeal dysphagia in adults. Direct and indirect approaches dysphagia has been described. Direct approach usually involves food, usually indirect approach without food bolus.

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