Swallowing Disorders Clinic

The Swallowing Disorders Clinic at Shepherd Center offers a comprehensive program for diagnosis and treatment of people who have mild to complex swallowing problems, known as dysphagia. Serious complications can include choking, malnutrition and lung infections, including pneumonia. Approximately 10 million people in the U.S. are evaluated each year for swallowing difficulties.

What Causes Dysphagia?
Swallowing problems can be caused by a number of things, such as stroke, brain injury or a spinal cord injury that has resulted in reduced coordination and movement of the swallowing mechanism. Because swallowing is a complex process, it's important to see an expert in speech-language pathology who specializes in swallowing disorders.

Symptoms (When to Refer)
Signs and symptoms of dysphagia may include:

Frequent coughing, throat clearing associated with eating or drinking

Complaint of sensation that food is stuck in throat

Difficulty breathing and/or wheezing when eating or drinking

Unexplained, low-grade, persistent fever

Recurrent pneumonia and/or chest congestion

Unexplained weight loss and/or dehydration or malnutrition

Associated Diagnosis
Patients who may be appropriate for the program could be experiencing swallowing problems secondary to:

Spinal Cord Injury

Acquired Brain Injury

Stroke

Multiple Sclerosis

Transverse Myelitis

Head/Neck Surgery

Parkinson's Disease

Amyotrophic Lateral Sclerosis (ALS)

Guillain-Barré Syndrome

Mechanical Ventilation or Tracheostomy

GERD or Reflux

Inflammatory myopathies such as dermatomyositis and ployositis

Esophageal strictures, achalasia, diffuse esophageal spasm, scleroderma

Diagnosis and Treatment
Shepherd Center uses advanced equipment to determine what is causing your swallowing difficulties and how they can be treated. Specific assessment and treatment modalities may include:

Modified Barium Swallow (MBS) study or Fiberoptic Endoscopic Evaluation of Swallowing (FEES)

Neuromuscular electrical stimulation and surface EMG for biofeedback to enhance use of traditional swallowing exercises for increased strength and range of motion

Referrals to ear, nose and throat specialists for assessment of vocal cord functioning or to a gastro-intestinal physician for dilatation or endoscopy to assess esophageal motility

Nutritional consult and diet education

Specialized Seating and Positioning

Written report to include interpretation of completed assessments, treatment plan and appropriate referrals