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There are dangerous complications
As explained by the Head of the Department of Geriatrics at LSMU Kaunas Hospital, Prof. Gytė Damulevičienė, the physiology of swallowing changes with age: the elasticity and breadth of muscle mass and connective tissue in the throat area decreases, thus as saliva production in the body decreases.
Symptoms of the disease include coughing, shortness of breath, choking, difficulty swallowing food or drink, weight loss, salivation, runny nose from food or food, changes in voice or speech such as hoarseness. “Usually a person does not subjectively feel the consequences of the usual tingling – a strong cough. For example, when he drinks tea, he can only constantly cook. But, in fact, at that moment, some of the liquid enters the windpipe. it is often seen as a consequence of old age and ways to help a person are not sought. According to the literature, about 75 percent cases of these disorders go undiagnosed, “said Prof. G. Damulevičienė.
Gytė Damulevičienė
© Photos of LSMU Kaunas Hospital
The consequences of a disease called oropharyngeal dysphagia are extremely painful. The disease causes dehydration, impaired kidney function, delirium, dry mouth, impaired immune system, muscle weakness, aspiration pneumonia, and other complications.
Importance of diagnostics
Early diagnosis of oropharyngeal dysphagia can prevent these complications. “Generally, geriatricians study and evaluate the patient’s reactions to drinking and eating foods of various consistencies. The fastest and most accurate diagnostic method is to assess swallowing with a video endoscope. During the procedure, a microcamera is inserted into the patient’s nasopharynx through the nose, transmitting the swallowing process from the inside to the screen. Doctors can record the data received and analyze in detail the severity of the disease and apply treatment measures accordingly, ”said prof. Gytė Damulevičienė.
Teacher. Gytė Damulevičienė (left) with a doctor Margarita Rugaitiene examines the patient’s swallowing processes with a video endoscope
© Photos of LSMU Kaunas Hospital
During the procedure, the patient is given to swallow a certain amount of liquid and solid food of a certain consistency. Oral anatomy, throat, salivary gland secretion, tongue involvement, pharyngeal wall movements, vocal cord motility, laryngeal closure, safety and efficacy of swallowing and other processes related to swallowing.
Until now, video endoscopic examinations for geriatric patients in Lithuania are applied only at LSMU Kaunas Hospital.
Deals
The treatment of oropharyngeal dysphagia is complex: electrostimulation of the muscles is applied to swallow, physical exercises, modified diet.
Specially prepared foods can be used to investigate the disorder. It is often difficult for a patient to swallow liquid drinks, so some have to give him a drink thickened with special thickeners. While there is no one-size-fits-all diet, what unites them all is that it is necessary to modify the consistency of solid foods and liquids. “A mild dysphagia diet should remove all small, coarse, hard food particles from dishes. For example, when preparing a meat dish, three consistencies are distinguished: minced in a few smaller bites, ground and grated. On a puree type diet, the food has a pudding consistency, is slippery and therefore becomes much easier to swallow than on a normal daily diet, ”said prof. G. Damulevičienė.
A swallowing disorder can be accurately assessed and analyzed with a video endoscope.
© Photos of LSMU Kaunas Hospital
Good results are obtained by transcutaneous electrical stimulation of the swallowing muscles. It is a treatment method in which weak electrical impulses stimulate the muscles in the neck area associated with swallowing. This prevents them from atrophying and completely losing their function. Strengthening these muscles also has a role in protecting the airways from aspiration.
Teacher. G. Damulevičienė emphasized that medicine can already treat ailments previously associated with old age and help a person preserve a dignified life for as long as possible. “As society ages, the science of geriatrics becomes more and more relevant. Therefore, we are pleased that the project of establishing a Geriatrics Center is currently being implemented at LSMU Kaunas Hospital. It will focus on geriatric services. for inpatients, outpatients and outpatients, ”reported Prof. G. Damulevičienė.
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