Areas of expertise / Dysphagia

Dysphagia

What are we talking about?

Dysphagia is the medical term for ‘difficulty swallowing’. Individuals afflicted with dysphagia may encounter impediments across multiple facets of deglutition, including sucking, imbibing, and masticating (1,2).

It is usually caused by a health condition such as a stroke, head injury, ageing or a progressive condition, e.g. Alzheimer´s, Parkinson’s disease or head and neck cancers (1,2,3).

Prevalence and consequences

Current estimates suggest that approximately 20% of the general population will experience dysphagia at some point in their lifetime. Among individuals aged 60 and older, the prevalence increases dramatically, with 50% to 66% affected. This prevalence remains significant within high-risk groups, where up to 53% may suffer from dysphagia (1,2).

Dysphagia hampers nutrient intake, leading to weight loss, malnutrition, dehydration, and an increased risk of aspiration pneumonia and asphyxia, with subsequent anxiety and sociopsychological disorders. These challenges contribute to a poorer long-term prognosis and quality of life, often resulting in extended hospital stays, higher rates of hospital readmissions, and an elevated risk of mortality (1,2,3).

The role of oral nutritional supplements

The specific use of oral nutritional supplements, by offering a personalized and nutritionally rich option, is key to preventing the serious complications resulting from insufficient nutrition and hydration. This strategy plays an essential role in the clinical support and recovery process of patients.

According to the ESPEN Guidelines, texture-modified foods are recommended for individuals with oral dysphagia. By adjusting the viscosity of liquids and foods, thickeners play a crucial role in ensuring a safer swallowing process by slowing down the transit time. This preventative measure is essential in avoiding aspiration, which can lead to serious health complications such as pneumonia and choking. Consequently, it significantly diminishes the chances of hospital admissions and mortality (4).

Frequent questions

1. Can dysphagia affect everyone?

Dysphagia affects individuals across all age groups and societal backgrounds. It may arise from a variety of causes, such as accidents, traumas, neoplastic diseases and their treatments, as well as degenerative and pulmonary disorders. Additionally, it can manifest in newborns due to congenital malformations (1,3).

2. Why is dysphagia often not diagnosed or treated despite its prevalence?

Dysphagia is often described as an ‘invisible condition’. Although it is widespread, swallowing disorders frequently remain undetected. This is largely due to a widespread lack of understanding about these conditions, resulting in many individuals not seeking medical advice for their symptoms, which could often be managed or treated. Additionally, some may face barriers to accessing professional treatment or care (3).

3. What are the benefits of using xanthan gum thickener in the treatment of dysphagia?

Xanthan gum-based thickeners are preferred in dysphagia management due to their stable viscosity across diverse temperatures and pH levels, compatibility with different foods and beverages, and resistance to saliva’s amylase. Their shear-thinning properties also ensure safer swallowing by lowering viscosity under stress. Conversely, starch-based thickeners exhibit less consistent viscosity, especially with temperature fluctuations, potentially complicating swallowing control (5).

Bibliography

  1. European Society for Swallowing Disorders (ESSD). What is Dysphagia. 2024.
  2. Chen K. Research progress in the risk factors and screening assessment of dysphagia in the elderly. Front. Med. 2022.
  3. Rommel N. Oropharyngeal dysphagia: manifestations and diagnosis. Nat Rev Gastroenterol Hepatol. 2015.
  4. Thibault R. ESPEN guideline on hospital nutrition. Clin. Nutr. 2021.
  5. Rofes L. The effects of a xanthan gum-based thickener on the swallowing function of patients with dysphagia. Aliment  Pharmacol  Ther. 2014.

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