Updated February 06, 2013.

Question: How is Swallowing Evaluated?

Answer:

Strokes, cancer and other illnesses can lead to difficulty swallowing. At first, difficulty swallowing can be subtle and not necessarily reveal itself as a true problem. The evaluation of swallowing typically begins by seeking consultation with a speech and language pathologist. He will ask you about the specific problems you are having when you swallow.

Commonly reported problems include:

Chocking after drinking thin liquids, such as water or orange juice

Difficulty swallowing foods that are difficult to chew

A sensation that food is stuck in your throat or in the middle of your chest

A need to cough every time you swallow solid or liquid foods

Changes in your voice after eating (prolonged periods of hoarseness)

Frequent respiratory infections

Frequent pooling of saliva in the mouth

Frequent episodes of indigestion

Progressive, unintended weight loss

Taking a long time to finish each meal
When one or more of these are found, the speech and language pathologist might want to order further tests in order to pinpoint specifically the type dysfunction which is causing the problem.

Common tests used in the evaluation of the swallowing mechanism include:

Barium swallow

Modified Barium Swallow

Reflux Monitoring

Upper Endoscopy
When difficulty swallowing (dysphagia) is expected to occur, such as is the case after an already diagnosed brainstem stroke, or after known trauma to any part of the swallowing apparatus, the speech therapist might be able to design a plan of therapy without the need of further tests.

However, when dysphagia is unexpected and cannot be explained by the tests mentioned above, consultation with an ear nose and throat (ENT), or gastroenterology specialist is needed, as your specific symptoms can be a sign of unexpected damage to the vocal cords or other areas of the swallowing apparatus, or intestinal, esophageal or gastric dysfunction.

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