Techniques to Improve Swallowing Difficulties with Multiple Sclerosis

Understanding Dysphagia and Swallowing Difficulties in Multiple Sclerosis

Difficulty swallowing, known medically as dysphagia, is a symptom that affects many people living with multiple sclerosis (MS). Issues with swallowing can significantly impact quality of life and even lead to medical complications if precautions aren't taken.

What Causes Dysphagia in MS?

Dysphagia occurs due to damage of myelin along nerve fibers in the central nervous system, caused by MS disease progression. Myelin is a fatty insulating layer that coats nerves, supporting effective transmission of nerve impulses. When myelin is damaged, it disrupts signals traveling to and from the brain regarding muscular control.

In the case of swallowing difficulties, weakened signals to throat and esophagus muscles make it harder to move food and liquid along. This may result in food sticking in the throat or liquid incorrectly entering the airway leading to the lungs.

Assessing Severity of Dysphagia

Those living with MS who experience occasional mild difficulties swallowing certain foods may simply need to avoid problematic items. However, recurring issues that interfere with nutrition, hydration or breathing due to aspiration risks require medical assessment.

Doctors can analyze swallow function in several ways to gauge dysphagia severity, determine appropriate treatment protocols, and rule out other possible causes. Approaches may include:

• Questionnaires regarding symptoms and impact
• Visual examinations
• Physical manipulation of throat tissues
• Recording equipment to view swallows
• Specialized imaging

Goals for Management of Dysphagia

After thoroughly evaluating swallowing ability, physicians develop individually-tailored dysphagia management plans aimed at different goals that improve safety and quality of life. Target outcomes include:

• Ensuring adequate hydration and nutrition
• Adapting food textures for easier swallowing
• Teaching proper head and neck positioning
• Strengthening oral and throat muscles
• Compensating for weakened swallows
• Preventing aspiration of food and liquid

Techniques to Improve Swallow Function and Safety

Many techniques and strategies can help those living with MS manage dysphagia challenges. Working with a supportive medical team, individuals can explore options to identify those most effective for their situations.

Changing Diet Textures

Altering the textures of foods and liquids to make them easier to manipulate and control when swallowing is a key strategy. Examples include:

• Pureeing solids to smooth, pudding-like consistencies
• Thickening liquids to flow more slowly and resist aspiration
• Chopping solid foods extremely finely or serving in small pieces
• Avoiding mixed consistencies like soups or cereal with milk

Practicing Mindful Eating Habits

Those living with dysphagia also benefit greatly from adapting their eating habits. Helpful tips include:

• Taking small bites/sips and thoroughly chewing/swallowing before continuing
• Allowing extra time for meals without feeling rushed
• Remaining upright while eating
• Taking breaks during meals if fatigue sets in
• Stopping immediately if coughing or choking occurs

Performing Swallowing Exercises

Specific swallowing exercises target muscle strengthening to improve control. These may be recommended by speech language pathologists before or during meals, such as:

• Tongue resistance exercises using tools
• Effortful swallows forcing extra muscle contraction
• Mendelsohn maneuver which holds the larynx up longer
• Thermal tactile stimulation using cooled vibrations
• Expiratory muscle strength training
• Oral motor skill exercises
• Biofeedback tasks monitoring muscle activity

Trying Assistive Devices or Techniques

Those with more significant swallowing impairment may benefit from customized assistance. Potential options include:

• Tube feeding formulas if meeting caloric goals by mouth becomes unsafe

Creating a Dysphagia Management Plan

After thorough evaluation, swallowing disorders should be treated with a tailored dysphagia management plan monitored by a coordinated healthcare team. This facilitates dietary modifications, skill training, and follow-ups to track progress and update approaches as needed.

With proper attention and support, those experiencing dysphagia due to MS can find relief through strategies enabling safer, easier swallowing and meals that remain positive experiences.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.