How is dysphagia diagnosed. What are the main types of dysphagia. How is high dysphagia treated. What dietary changes can help with dysphagia. When are feeding tubes necessary for dysphagia patients. How is low dysphagia managed. What surgical options exist for treating dysphagia.

Understanding Dysphagia: Types and Diagnosis

Dysphagia, commonly known as swallowing problems, can significantly impact a person’s quality of life. It’s crucial to understand the different types of dysphagia and how they are diagnosed to ensure proper treatment.

There are two main types of dysphagia:

• Oropharyngeal dysphagia (high dysphagia): Affects the mouth or throat
• Esophageal dysphagia (low dysphagia): Affects the esophagus

Diagnosis typically involves a thorough medical history, physical examination, and specialized tests such as videofluoroscopy or endoscopy. These tests help healthcare professionals determine the exact location and cause of the swallowing difficulty.

Treatment Approaches for High Dysphagia

High dysphagia, which affects the mouth and throat, can be challenging to treat, especially when caused by neurological conditions. However, several treatment options are available:

Swallowing Therapy

A speech and language therapist (SLT) plays a crucial role in managing high dysphagia. They employ various techniques tailored to each patient’s specific needs, including:

• Swallowing exercises to strengthen muscles
• Postural changes to facilitate safer swallowing
• Strategies to improve swallowing coordination

Can swallowing therapy cure dysphagia? While it may not always provide a complete cure, swallowing therapy can significantly improve swallowing function and safety for many patients.

Dietary Modifications

Adjusting the texture and consistency of food and drinks can make swallowing easier and safer for those with dysphagia. A dietitian may recommend:

• Softer foods that require less chewing
• Thickened liquids to slow down the flow
• Nutritionally dense foods to ensure adequate intake

How do thickened liquids help dysphagia patients? Thickened liquids move more slowly, giving the patient more time to control the swallow and reduce the risk of aspiration.

Feeding Tubes: When and Why They’re Used

In severe cases of dysphagia, feeding tubes may be necessary to ensure proper nutrition and hydration. There are two main types:

1. Nasogastric tubes: Inserted through the nose into the stomach, suitable for short-term use
2. Percutaneous endoscopic gastrostomy (PEG) tubes: Implanted directly into the stomach, designed for long-term use

Are there risks associated with feeding tubes? While feeding tubes can be life-saving, they do carry some risks, including infection, tube displacement, and potential complications during insertion. The benefits and risks should be carefully discussed with the healthcare team.

Managing Low Dysphagia: Esophageal Treatment Options

Low dysphagia, affecting the esophagus, often requires different treatment approaches compared to high dysphagia. Here are some common interventions:

Medication Therapy

Certain medications can help manage symptoms of low dysphagia. For instance, proton pump inhibitors (PPIs) may be prescribed to reduce acid reflux and alleviate symptoms caused by esophageal narrowing or scarring.

Can medication alone treat low dysphagia? While medication can be effective in some cases, it’s often used in combination with other treatments for optimal results.

Botulinum Toxin Injections

For conditions like achalasia, where the esophageal muscles become too stiff, botulinum toxin injections can provide temporary relief. This treatment works by paralyzing the overly tight muscles, allowing food and liquid to pass more easily.

How long do the effects of botulinum toxin last? The effects typically last for about six months, after which the treatment may need to be repeated.

Surgical Interventions for Low Dysphagia

In many cases of low dysphagia, surgical intervention may be necessary. One common procedure is endoscopic dilatation:

• An endoscope is used to guide a small balloon or bougie into the narrowed part of the esophagus
• The balloon is inflated or the bougie is passed through to stretch and widen the esophagus
• This procedure can be effective for dysphagia caused by obstruction or scarring

Is endoscopic dilatation a permanent solution? While it can provide significant relief, some patients may require repeat procedures if the narrowing recurs.

The Role of Multidisciplinary Teams in Dysphagia Management

Effective dysphagia treatment often requires a collaborative approach involving various healthcare professionals. A multidisciplinary team (MDT) typically includes:

• Speech and language therapists
• Dietitians
• Surgeons
• Gastroenterologists
• Neurologists (in cases of neurological dysphagia)

How does a multidisciplinary approach benefit dysphagia patients? By combining expertise from different specialties, MDTs can provide comprehensive care that addresses all aspects of the patient’s swallowing difficulties, from diagnosis to treatment and long-term management.

Innovative Treatments and Future Directions in Dysphagia Care

As research in dysphagia continues to evolve, new treatment options are emerging. Some innovative approaches include:

• Neuromuscular electrical stimulation (NMES) to strengthen swallowing muscles
• Virtual reality-based swallowing therapy for more engaging rehabilitation
• Gene therapy for certain genetic causes of dysphagia

What role might artificial intelligence play in dysphagia treatment? AI could potentially help in more accurate diagnosis, personalized treatment planning, and even in guiding robotic interventions for complex cases of dysphagia.

Living with Dysphagia: Coping Strategies and Support

Beyond medical treatments, there are various strategies that can help individuals cope with dysphagia in their daily lives:

• Using adaptive utensils and cups designed for easier swallowing
• Practicing mindful eating techniques
• Joining support groups to connect with others facing similar challenges
• Working with occupational therapists to develop strategies for meal preparation and eating

How can family members support someone with dysphagia? Family support is crucial and can include helping with meal preparation, ensuring a calm eating environment, and providing emotional support during challenging times.

Preventing Complications: The Importance of Proper Dysphagia Management

Effective management of dysphagia is not just about improving quality of life; it’s also crucial for preventing serious complications. Some potential risks of untreated or poorly managed dysphagia include:

• Aspiration pneumonia
• Malnutrition and dehydration
• Choking
• Social isolation due to difficulties with eating and drinking

How can regular follow-ups help prevent dysphagia complications? Regular check-ups allow healthcare providers to monitor the progression of dysphagia, adjust treatments as needed, and catch any potential complications early.

In conclusion, dysphagia is a complex condition that requires a multifaceted approach to treatment. From swallowing therapy and dietary modifications to advanced surgical interventions, the range of available treatments offers hope for many individuals struggling with swallowing difficulties. As research continues to advance, we can expect even more innovative and effective treatments to emerge, further improving the lives of those affected by dysphagia.

Understanding the nuances of dysphagia and its treatment options empowers patients and caregivers to make informed decisions and actively participate in the management of this challenging condition. With the right combination of medical interventions, lifestyle adjustments, and support, many individuals with dysphagia can achieve significant improvements in their swallowing function and overall quality of life.

As we look to the future, continued research and development in the field of dysphagia treatment promise to bring even more advanced and personalized solutions. From cutting-edge technologies to refined therapeutic techniques, the landscape of dysphagia care continues to evolve, offering new hope and possibilities for those affected by this condition.

Ultimately, the key to successful dysphagia management lies in a comprehensive, patient-centered approach that addresses not only the physical aspects of swallowing difficulties but also the emotional and social impacts of the condition. By combining medical expertise with compassionate care and ongoing support, healthcare providers can help individuals with dysphagia navigate their challenges and achieve the best possible outcomes.

Dysphagia (swallowing problems) – Illnesses & conditions

Most swallowing problems can be treated, although the treatment you receive will depend on the type of dysphagia you have.

Treatment will depend on whether your swallowing problem is in the mouth or throat (oropharyngeal, or “high” dysphagia), or in the oesophagus (oesophageal, or “low” dysphagia).

The cause of dysphagia is also considered when deciding on treatment. In some cases, treating the underlying cause, such as mouth cancer or oesophageal cancer, can help relieve swallowing problems.

Treatment for dysphagia may be managed by a group of specialists known as a multidisciplinary team (MDT). Your MDT may include a speech and language therapist (SLT), a surgeon, and a dietitian.

High (oropharyngeal) dysphagia

High dysphagia is swallowing difficulties caused by problems with the mouth or throat.

It can be difficult to treat if it’s caused by a condition that affects the nervous system.  This is because these problems can’t usually be corrected using medication or surgery.

There are 3 main treatments for high dysphagia:

• swallowing therapy
• dietary changes 
• feeding tubes

Swallowing therapy

You may be referred to a speech and language therapist (SLT) for swallowing therapy if you have high dysphagia.

An SLT is a healthcare professional trained to work with people with feeding or swallowing difficulties.

SLTs use a range of techniques that can be tailored for your specific problem, such as teaching you swallowing exercises.

Dietary changes

You may be referred to a dietitian (specialist in nutrition) for advice about changes to your diet to make sure you receive a healthy, balanced diet.

An SLT can give you advice about softer foods and thickened fluids that you may find easier to swallow. They may also try to ensure you’re getting the support you need at meal times.

Feeding tubes

Feeding tubes can be used to provide nutrition while you’re recovering your ability to swallow. They may also be required in severe cases of dysphagia that put you at risk of malnutrition and dehydration.

A feeding tube can also make it easier for you to take the medication you may need for other conditions.

There are 2 types of feeding tubes:

• a nasogastric tube – a tube that is passed down your nose and into your stomach
• a percutaneous endoscopic gastrostomy (PEG) tube – a tube that is implanted directly into your stomach

Nasogastric tubes are designed for short-term use. The tube will need to be replaced and swapped to the other nostril after about a month. PEG tubes are designed for long-term use and last several months before they need to be replaced.

Most people with dysphagia prefer to use a PEG tube because it can be hidden under clothing. However, they carry a greater risk of complications compared with nasogastric tubes.

Minor complications of PEG tubes include tube displacement, skin infection, and a blocked or leaking tube. 2 major complications of PEG tubes are infection and internal bleeding.

Resuming normal feeding may be more difficult with a PEG tube compared with using a nasogastric tube. The convenience of PEG tubes can make people less willing to carry out swallowing exercises and dietary changes than those who use nasogastric tubes.

You should discuss the pros and cons of both types of feeding tubes with your treatment team.

Low (oesophageal) dysphagia

Low dysphagia is swallowing difficulties caused by problems with the oesophagus.

Medication

Depending on the cause of low dysphagia, it may be possible to treat it with medication. For example, proton pump inhibitors (PPIs) used to treat indigestion may improve symptoms caused by narrowing or scarring of the oesophagus. 

Botulinum toxin

Botulinum toxin can sometimes be used to treat achalasia. This is a condition where the muscles in the oesophagus become too stiff to allow food and liquid to enter the stomach.

It can be used to paralyse the tightened muscles that prevent food from reaching the stomach. However, the effects only last for around 6 months.

Surgery

Other cases of low dysphagia can usually be treated with surgery.

Endoscopic dilatation

Endoscopic dilation is widely used to treat dysphagia caused by obstruction. It can also be used to stretch your oesophagus if it’s scarred.

Endoscopic dilatation will be carried out during an internal examination of your oesophagus (gastroscopy) using an endoscopy.

An endoscope is passed down your throat and into your oesophagus, and images of the inside of your body are transmitted to a television screen.

Using the image as guidance, a small balloon or a bougie (a thin, flexible medical instrument) is passed through the narrowed part of your oesophagus to widen it. If a balloon is used, it will be gradually inflated to widen your oesophagus before being deflated and removed.

You may be given a mild sedative before the procedure to relax you. There’s a small risk that the procedure could cause a tear or perforate your oesophagus.

Find out more about gastroscopy.

Inserting a stent

If you have oesophageal cancer that can’t be removed, it’s usually recommended that you have a stent inserted instead of endoscopic dilatation. This is because, if you have cancer, there’s a higher risk of perforating your oesophagus if it’s stretched.

A stent (usually a metal mesh tube) is inserted into your oesophagus during an endoscopy or under X-ray guidance.

The stent then gradually expands to create a passage wide enough to allow food to pass through. You’ll need to follow a particular diet to keep the stent open without having blockages.

Congenital dysphagia

If your baby is born with difficulty swallowing (congenital dysphagia), their treatment will depend on the cause.

Cerebral palsy

Dysphagia caused by cerebral palsy can be treated with speech and language therapy. Your child will be taught how to swallow, how to adjust the type of food they eat, and how to use feeding tubes.  

Cleft lip and palate

Cleft lip and palate is a facial birth defect that can cause dysphagia. It’s usually treated with surgery. 

Narrowing of the oesophagus

Narrowing of the oesophagus may be treated with a type of surgery called dilatation to widen the oesophagus. 

Gastro-oesophageal reflux disease (GORD)

Dysphagia caused by gastro-oesophageal reflux disease (GORD) can be treated using special thickened feeds instead of your usual breast or formula milk. Sometimes medication may also be used.

Breastfeeding or bottle feeding

If you’re having difficulty bottle feeding or breastfeeding your baby, see your midwife, health visitor or GP

Causes, Prevention, and Treatment of Choking

Choking happens when something—food or another item—is caught in the back of the throat. If the object (or food) blocks the top of the trachea a person may be unable to breathe. This is an emergency. It is also possible that food or other things can get stuck in the esophagus; while painful, this does not cause a person to stop breathing. This article will cover causes, prevention and the treatment of choking.

Science Photo Library / Getty Images 

Causes

Certain medical conditions or circumstances can make a person more likely to choke. Risk factors include (but are not limited to):

• Children under the age of 5
• The elderly
• People with neurological illnesses
• People with diseases that cause muscular degeneration, such as multiple sclerosis
• Disorders of the esophagus such as a narrowed esophagus due to chronic acid reflux (GERD)
• People with anatomical genetic abnormalities that affect the swallowing process (cleft lip for example)
• People with injuries that affect the swallowing process

Additionally, certain activities or habits can also increase your risk of choking:

• Eating too quickly
• Not sitting down while eating
• Not chewing food properly
• Eating while lying down

Prevention

Children under the age of 5 have an increased risk of choking.  Both cognitive development and anatomic differences in children cause an increased risk in this age group. Small children lack the ability to differentiate what objects may get stuck in their throats. This is often during their oral phase of development when they put everything into their mouths.

As your child gets older, they still remain at risk due to their smaller airway. The risk, however, decreases because cognitively, they become more aware of which items are safe to put in their mouths. While completely child-proofing your home is near impossible, keeping certain objects away from small children can go a long way toward preventing choking.

Common Choking Hazards

• Latex balloons – leading cause of death in children under the age of 6
• Balls
• Marbles
• Coins (18% of choking-related ED visits for children 1 to 4 years old)
• Disc batteries (also called button batteries and are especially dangerous because when swallowed there is a possibility they will leak toxic alkaline contents into the digestive tract. )
• Small toys – some say that if an object can fit inside a roll of toilet paper your child can choke on it.
• Caps (pen or marker caps especially)
• Safety pins

High-Risk Foods

• Hot dogs – most common fatal food-related hazard
• Hard candy – (19% of choking-related emergency room visits)
• Grapes
• Nuts
• Raw carrots
• Apples
• Marshmallows
• Popcorn
• Peanut butter

Approximately 60% of non-fatal choking hazards are caused by food items . Foods that are choking hazards are foods that can be compressed to fit the size of the airway. In addition to the foods listed above,​ you should not give a small child, elderly person or any individual who has difficulty swallowing, foods that are difficult to chew or are a size or shape that will easily become compressed in the airway.

Supervision is also one of the single most important factors to help prevent choking. One hundred percent supervision is usually not possible but should be implemented as much as possible when children under 5, elderly persons, or a person with a history of swallowing difficulties are eating. Keeping small objects out of reach and purchasing appropriate age level toys can also help prevent non-food related choking. Also, not allowing children to run and play while eating food or candy can help prevent choking on food.

Some other good prevention tips include:

• Eating food only at the table
• Cooking vegetables until they are soft
• Cutting hotdogs and other food items into pieces that are less than 1/2 inch and avoid cutting into round shapes
• Encouraging adequate chewing – this might not be mastered until your child is 4 years old
• Limiting distractions while eating
• Having a drink available while eating – avoid swallowing food and liquid at the same time
• Some individuals with swallowing problems (dysphagia) should only drink thickened liquids

What Should I Do If Someone Is Choking?

If someone is choking, you should determine whether or not they can talk. If they can talk, cough or make other noises that indicate air passage, let them clear their airway on their own. Intervention at this point may cause further lodging of the object to occur.

If an individual has something caught in the esophagus they will still be able to speak and breathe but it may be painful, especially when swallowing. They may also drool. You should seek medical attention so the object can either be retrieved or pushed into the stomach/intestines using a scope (EGD).

If the person choking is not able to speak or make other noises, they will not be able to breathe either. An indication that a person is not breathing is cyanosis. This is an emergency. You should start abdominal thrusts, also known as the Heimlich maneuver. If the person at any point becomes unresponsive (unconscious), you should begin CPR. If you are not alone, have someone else call 9-1-1. If you are alone call 911 immediately and (if possible) stay on the line while performing CPR.

Prevention is key when it comes to choking. Educating yourself on common causes of choking can help prevent complications from occurring and keep your loved ones safe.

Choking Symptoms, Causes & Common Questions

Musculoskeletal causes

Weakness of the muscles of the mouth or throat can make swallowing less effective or less orderly, leading to choking.

Allergic reactions

Severe allergic reactions can cause swelling in the back of the mouth that can block airflow and cause a choking sensation.

Infectious causes

Rarely, an infection in the back of the throat can lead to swelling significant enough to block the airway, leading to a choking sensation.

This list does not constitute medical advice and may not accurately represent what you have.

Panic disorder

Panic disorder is a chronic condition that involves repeated episodes of panic attacks, as well as worry about future attacks or consequences of attacks, or unhelpful changes in behavior to avoid the attacks. Panic attacks are episodes of sudden-onset fear, discomfort, and/or other symptoms tha…

Esophageal obstruction (steakhouse syndrome)

When a large piece of food or an object gets stuck in the lower esophagus, it can produce some mild chest pain and excessive salivation (drooling).

Rarity: Rare

Top Symptoms: vomiting, deep chest pain, behind the breast bone, trouble swallowing, choking, swallowing of something potentially harmful

Symptoms that always occur with esophageal obstruction (steakhouse syndrome): swallowing of something potentially harmful

Urgency: Hospital emergency room

Foreign body aspiration

Foreign body aspiration can be a life-threatening emergency. An aspirated solid or semisolid object may lodge in the larynx or trachea. If the object is large enough to cause nearly complete obstruction of the airway, asphyxia may rapidly cause death.

Rarity: Ultra rare

Top Symptoms: cough, fever, shortness of breath, cough with dry or watery sputum, wheezing

Symptoms that always occur with foreign body aspiration: swallowing of something potentially harmful

Urgency: Emergency medical service

Knowing the Signs and What to Do

Every five days, one child will die from choking in the United States. Choking is the fourth leading cause of death in children under five years of age.  For parents, these are pretty scary statistics! But the good news is that most of these deaths are preventable. Education on causes, prevention and what to do if your child is choking can impact your child’s chance of survival.  This is precisely what I hope to illustrate in this blog post, including helpful information about:

• Prevention
• Troublesome Foods
• Dangerous Household Items
• Signs of Choking
• What to do When a Child is Choking

What is Choking?

Choking occurs when something is blocking the airway, rendering a child unable to breathe.

Airway Sizes

Children have airways that are 1/3 the size of an adult.  Their windpipes or breathing tubes are approximately the size of a drinking straw.  As they grow, the size of their pinky finger is a good gauge for the size of their airway.

Partial Blockage

If a child can speak or cough the airway is only partially blocked.  If partial blockage occurs, you need to call 911. DO NOT attempt to open airway, but DO encourage the child to cough.

Prevention-Lower Risks in Your Child’s Environment

It’s impossible to eliminate every single thing from your environment that might cause your child to choke. But there are many things parents can remove from the environment to lower a child’s risk for choking. Some common choking hazards include toys, household items and food.  Of these, food is the most common cause of choking. Safe Eating Practices for Kids Accompanying your child while they eat not only provides an opportunity for bonding, but also ensures you’ll see if they’re chewing their food properly.  Sitting while eating and not doing anything else—like riding in a car or playing—is the safest way for children to enjoy their meal. An unhurried meal and snack time gives a child ample time to chew their food.  This is also a good time to lead by example with good posture, which is key to helping them chew and swallow solid foods.

Preparing Foods to Avoid Choking Hazards

Food is safest for children when it has been a) cut into small pieces and b) seeds and pits have been removed.  Here are some examples of ways to prepare common foods to make them safer for children:

• Cut hot dogs into bite-size pieces (cutting both length and width-wise)
• Soften vegetables by cooking or steaming them (this makes them easier to chew)
• Sticky foods should be consumed in small amounts (for example, peanut butter or cream cheese consumed in large “globs” can stick to the roof of a child’s mouth)
• Drink liquids between mouthfuls, rather than together with food

Foods That Cause Choking

Foods that are the most commonly associated with children choking include:

• Candy (specifically, hard candy)
• Caramels
• Cheese (specifically, cubed cheese)
• Chips
• Fruits (specifically, fruit with skins)
• Grapes (specifically, whole grapes)
• Gum
• Ice cubes
• Lollipops
• Marshmallows
• Nuts
• Peanut butter
• Popcorn
• Pretzels
• Raisins
• Vegetables (specifically, raw vegetables)

Cutting up foods into small pieces and using methods of food preparation that make it easier to chew can lessen the risk of a child choking while eating these foods.

Household Items that Cause Choking

Toys are a big source of choking hazards.  Deflated or broken latex balloons are especially dangerous since the balloons can stick to the breathing tube and be difficult to remove. Make sure smaller children can’t get hold of toys with small parts intended for older kids. Follow the age recommendations on toy packages. Here’s a list of more items that can pose a choking hazard to children and should be placed out of reach of little ones. These items should be placed out of the reach of older siblings, who might accidentally give them to younger siblings.

• Balloons
• Batteries
• Bolts
• Bottle caps (including syrup and soda caps)
• Coins
• Crayons (specifically, broken crayons)
• Doll accessories
• Erasers
• Jewelry (rings, earrings, pins, etc.)
• Nails, bolts, and screws,
• Paper clips
• Safety pins
• Screws
• Small balls
• Small office supplies (brads, pushpins, etc. )
• Tacks
• Toys with small parts

Use a Choke Tube Guide

Parents can use a choke tube guide (also known as a small parts tester), a plastic device available in most baby stores, to see if a toy is a choking risk. However, a toilet paper roll works just as well. The following websites also have great tips regarding choking prevention for parents.

Recognize Choking Signs and React

Signs of Choking

• Child begins to cough, gag or has high-pitched, noisy breathing
• An older child (over 1 year of age) may hold neck with both hands
• The child’s lips and/or skin may turn blue

What to do When a Child is Choking

• If the child is unable to speak or cough, give the Heimlich Maneuver.
• If the child is no longer breathing you need to shout for help, place the child on the ground and follow the next steps.
• If you are alone, start CPR. (Sign up for CPR classes.)
• Continue CPR until child moves or help arrives.  If you are alone, after 5 cycles or 2 minutes of CPR, leave the child and call 911.
• Continue to push on the stomach until the object is out and the child can talk and breathe or until the child is no longer breathing.

Saving Lives

Educating yourself with these few, simple steps to ensure a safe environment for your child, could help save their lives. Sharing this information with other parents is a great way to empower others to do the same.

Dysphagia (Ear, Nose & Throat)

Dysphagia is the medical term for difficulty swallowing.  Dysphasia is usually a sign that there is a problem with your esophagus, the muscular tube that moves food and liquids from the back of your mouth to your stomach.

If dysphagia is severe, you may not be able to take in enough fluids and calories to stay healthy. In severe cases, even saliva is difficult to swallow. Complications may include aspiration pneumonia (when food or liquids are pulled into your lungs), malnutrition, dehydration, weight loss and airway blockage.

Anyone can have dysphagia, but it is more common in older adults, babies and people who have brain or nervous system conditions.

There are two types of dysphagia (diss-PHASE-yee-ah):

• Esophageal (ah-soff-a-GEE-el) dysphagia — Caused by narrowing of the esophagus or a disruption in normal esophageal movement.
• Orophargyneal (ora-far-rah-GEE-el) dysphagia — Caused by problems getting food from the mouth into the upper esophagus. Neurological conditions such as a stroke or Parkinson’s disease are frequently to flame. Inflammation or cancer of the mouth also can lead to this condition. 

Cause

When food and liquids have trouble moving from your mouth to your stomach, there are usually two types of problems:

• The muscles and nerves that help move food through the throat and esophagus are not working properly. This can happen if you have had medical conditions such as a stroke, brain or spinal cord injury; certain nervous or immune system problems; or scleroderma. 
• Something is blocking your throat or esophagus, which could happen if you have conditions such as gastroesophageal reflux disease (GERD), esophagitis, diverticula, esophageal tumors or masses outside the esophagus. 

Signs and Symptoms

Typical symptoms include:

• Trouble swallowing
• Coughing or choking with eating or drinking
• Constant feeling of a lump in the throat
• Pain with swallowing
• Drooling
• Recurrent pneumonia
• Nasal sounding voice
• Sensation of food sticking in the chest
• Weight loss

Diagnosis

Dysphagia can be difficult to diagnose because it mimics other symptoms. That is why it is important to be seen by a skilled team of experts who are familiar with diagnosing and treating dysphagia. 

The University of Michigan Vocal Health Center team will ask you about your symptoms and medical history, and then do a thorough head and neck examination. During this process, we will also assess your vocal quality, vocal efficiency and speaking technique. 

We may need to conduct one or more tests, including:

• X-rays
• Laryngoscopy – This test looks at the back of your throat with a fiber-optic scope
• Upper gastrointestinal endoscopy – During this test, also referred to as an “upper GI,” a small scope will be placed in your mouth and down your throat to look at your esophagus and perhaps your stomach and upper intestines. Sometimes, a small piece of tissue is removed for a biopsy (a test that checks for inflammation or cancer cells). 
• Manometry
• pH monitoring

Treatment

The treatment for dysphagia depends upon what is causing the problem. We have options such as: 

• Endoscopic dilation – In this procedure, the esophagus is gradually stretched using special dilators or a balloon inserted through an endoscope and then inflated. Surgery or radiation therapy may be necessary to treat esophageal tumors that have narrowed the esophagus.
• Endoscopy – A long, thin scope can be used to remove an object that is stuck in your esophagus.
• Food and liquid changes – We may recommend foods and liquids with textures that are safer and easier for you to swallow.
• Speech-language-voice therapy – This may involve special exercises, body positions and other techniques to improve your ability to swallow. 
• Surgery – If you have a blockage of some sort, you may need surgery to remove it. 

Make an Appointment

Schedule an appointment by calling us at 734-936-8051.

Choking on Water: Why Do Elderly Adults Have Difficulty Swallowing?

Have you noticed your senior loved one choking on water? Learn why elderly adults have difficulty swallowing sometimes and what you can do to help here.

Difficulty swallowing — also known as dysphagia — is a common condition among senior citizens. It affects approximately 15 percent of all elderly adults.

Is your elderly parent or loved one choking on water or having trouble swallowing? If so, you know how scary it can be trying to help them. You might even feel helpless.

If you’re tired of feeling this way, or if you just want to be prepared for potential problems in the future, keep reading.

Everything you need to know about swallowing difficulties is explained below, along with information on you can prevent and treat them.

Symptoms of Dysphagia

It can sometimes be difficult to tell if an elderly loved one is suffering from dysphagia. Choking on water or food on a regular basis is an obvious symptom.

Some other symptoms are more subtle, though. The following are some of the most common symptoms of this condition:

• The voice taking on a gurgling sounding, especially after they’ve eaten or had something to drink
• Drooling
• Taking a long time to finish a meal
• Losing weight without trying because they’re avoiding eating or drinking

If you notice any of these symptoms, your loved one may be suffering from dysphagia.

Reasons for Dysphagia and Choking on Water

Why can it be so hard for elderly adults to swallow? There are a number of conditions that seniors can experience that can cause dysphagia, including the following:

• Poor oral health or poorly fitting dentures
• Acid reflux
• Side effects from certain medications
• Stroke
• Cognitive disorders (such as Alzheimer’s or dementia)
• Cancer of the throat, mouth, or esophagus

Sometimes, dysphagia is just a normal sign of aging. As people get older, sometimes their mouth and throat muscles begin to weaken. This, in turn, can lead to swallowing difficulties.

Diagnosing Dysphagia

If you suspect your elderly loved one has dysphagia, they’ll need to see a doctor right away. A doctor will use the following techniques to determine whether or not dysphagia is the problem:

• A swallow test that involves being x-rayed after swallowing a contrast solution and while swallowing a variety of liquids with different consistencies
• Visual examinations of the esophagus
• Endoscopic swallowing tests
• Esophageal muscle tests

These techniques will also help the doctor to determine what is causing the dysphagia.

Treating Swallowing Difficulties

If it turns out that your loved one does suffer from dysphagia, the following tips can help you to manage their condition effectively:

Proper Medication Administration

Individuals with aphasia should not be given pills to take with water. This can increase their risk of choking.

Instead, their pills should be administered with a thick liquid, such as a smoothie.

They can also be crushed up and mixed with a thick, easy-to-swallow food like pudding or applesauce. Make sure the food is sweet or has a strong flavor — this helps to mask the taste of the medication.

Maintain Hydration

It’s easy for elderly adults to become dehydrated when they suffer from dysphagia. If they can’t drink plain water, they might just not drink anything at all.

In order to help your loved one stay hydrated, their drinks will need to be thickened. There are lots of products, including thickening powders and gels, that will make their drinks safe to swallow.

Avoid Straws

Do not give your loved one liquids to drink through a straw. Straws increase the amount of liquid they can consume at one time.

This might seem like a good idea at first, but it can actually make life harder for your loved one. If they get too much liquid at once, they’re more likely to choke and have trouble swallowing.

Dietary Changes

In addition to changing up their drinks, you’ll also need to change the type of food your loved one consumes. Your loved one should eat foods that are soft and easy to consume.

Yogurt, peanut butter, pureed vegetables, and thickened soup are all good options.

Focus on giving your loved one high-calorie, nutrient-dense foods, especially if they are losing a lot of weight. Adding these foods to their diet will help them maintain their weight and avoid nutrient deficiencies.

Improved Posture

When your loved one is eating or drinking, they need to be sitting up straight in their bed or in their wheelchair.

This makes it easier for their food and drinks to go down and decreases their risk of choking. You may need to adjust their back or hold their head up to support them while they eat or drink.

Swallowing Therapy

Your loved one may benefit from swallowing therapy, too. This can be especially helpful if their dysphagia is related to a stroke or other medical condition. They might be able to work with a specialist to minimize the severity of their condition and maintain their quality of life.

Feeding Tubes

In severe cases, individuals with dysphagia may need to use a feeding tube to get adequate nutrients in a safe way. These tubes are surgically implanted and are typically seen as a last resort.

Work with a Professional

As you can see, there are a lot of things you have to take into account when caring for a loved one with dysphagia.

If you’re feeling overwhelmed by all these different treatment techniques and options, you might want to consider hiring a home health aide or having your loved one live in an assisted living facility.

That way, they will get the care they need at all times, and it will be administered by a professional.

Get Help for Your Loved One Today

It can be scary when your elderly loved ones begin to have trouble swallowing and experience issues like choking on water.

It’s not fun to think about these things happening, either. At these same time, though, you need to know how to prevent and handle these situations to keep your loved one safe.

Keep these tips in mind so that you’re prepared in the event that your loved one begins to choke or have trouble swallowing.

Do you need help caring for your loved one and keeping them safe? If so, we can help at MediLodge.

Contact us today to learn more about our services or to schedule a personal tour of our facilities.

Choking – Better Health Channel

Air enters the lungs via the trachea (windpipe). Choking is caused when a foreign object, like a hard lump of food, a marble or false teeth goes into the trachea instead of the oesophagus (food pipe). If the object is at the entrance to the trachea (epiglottis), a good cough will more than likely push it out. If the object has made its way past the epiglottis, coughing may prevent the object from going further down the trachea. Sometimes, an inhaled object may cut off the airway completely.

Choking may be a life-threatening medical emergency, because the brain can only survive a few minutes without oxygen.

First aid can save the life of a choking person if applied correctly and immediately. Procedures are different for adults and children. Always call triple zero (000) in an emergency.

The suggestions in this fact sheet are not a substitute for first aid training. Everyone should learn first aid skills.

Symptoms of choking

A person with a partly blocked airway can still breathe, speak or cough. Symptoms include:

• Panicked and distressed behaviour
• Inability to talk in complete sentences or at full volume
• Frantic coughing
• Unusual breathing sounds, such as wheezing or whistling
• Clutching at the throat
• Watery eyes
• Red face.

If the person’s airway is completely blocked and they cannot breathe, speak or cough at all, they will show some or all of the above symptoms including vigorous attempts to breathe, then turning pale and then blue due to lack of oxygen (cyanosis), before collapsing into unconsciousness.

First aid for choking if the person is conscious

To begin with, reassure the person. Encourage them to breathe and cough. If coughing does not remove the blockage:

• Call triple zero (000).
• Bend the person well forward and give five back blows with the heel of your hand between their shoulderblades – checking if the blockage has been removed after each blow.
• If unsuccessful, give five chest thrusts by placing one hand in the middle of their back for support and the heel of the other hand on the lower part of their breastbone – checking if the blockage has been removed after each thrust.

The technique for adults and children is different from that required for babies. You will need to apply different methods for:

• An adult or child– ask the person to lean over with their hands on their knees or sit in a chair leaning forward. The amount of force used on a child is less than that used on an adult
• Baby – place the baby on your lap or forearm, with their head lower than their body. Ensure that you have them in a firm hold. The amount of force is less than that used on a child.

First aid for choking if the person is unconscious

If the person becomes unconscious:

• Call triple zero (000).
• Remove any visible obstruction from the mouth.
• Commence cardiopulmonary resuscitation (CPR).

Cardiopulmonary resuscitation (CPR) to treat choking

First aid CPR procedure includes:

• Place the person on their back on a hard surface such as the floor (place a baby on a table).
• Tilt the person’s head gently back, pinch the nostrils closed, cover their mouth with yours to create a seal and blow firmly. (Do not tilt a baby’s head back. Instead, cover their nostrils and mouth with your mouth. Blow in puffs.)
• Place the heel of one hand on the lower half of the person’s breastbone. Place the other hand on top of the first hand and interlock your fingers. Keep your fingers up so that only the heel of your hand is on the person’s chest. Use only one hand for children aged between one and eight. Use two fingers for babies.
• Press down firmly and smoothly (compressing to one third of chest depth) 30 times. Then administer two breaths. Repeat at the rhythm of five cycles in two minutes.
• Continue CPR and only stop when the ambulance officers take over or the person recovers.

Performing first aid on yourself

If you are choking:

• Try to stay calm. Attract someone’s attention for help.
• Attempt forceful coughing. Lean as far forward as you can. Hold onto something that is firmly anchored, if possible. Breathe out and then take a deep breath in and cough. This may eject the foreign object.
• Don’t let anyone slap you on the back while you are upright. Gravity may cause the object to slip further down your trachea (windpipe).

Children and choking

Treatment for a choking child or baby is slightly different than for an adult. The most important thing to remember is never to pat or slap your choking child on the back if they are managing to cough. Your actions may dislodge the object and allow it to be inhaled deeper into the airway.

Note that in a young child, their struggle to breathe may not last long and the stopping of frantic activity may signal a serious or life-threatening situation, rather than a sign that they have dislodged the blockage. Look for other signs and symptoms such as the child’s responses, a pale face, or cold and clammy skin. These are signs that the child is in shock.

Immediate steps when a child is choking

When a child is choking:

• Immediately check if the child is still able to breathe, cough or cry. If so, they may be able to dislodge the object by coughing.
• Do not try to dislodge the object by hitting the child on the back or squeezing the stomach – this may move the object into a more dangerous position and cause the child to stop breathing.
• Stay with the child and watch to see if their breathing improves.
• If the child is not breathing easily within a few minutes, call triple zero (000).
• If, after the coughing settles down, there is any continued noisy breathing or coughing, take the child to see a doctor, as the object may have lodged in the windpipe or airway. If this is the case, it will need to be removed in hospital using a special instrument.

What to do when the child is not breathing

If the child is not breathing:

• For a young child (under about five years), place the child face down over your lap so that the head is lower than the chest. For an older child, lay them on their side. Give four sharp blows on the back between the shoulder blades to dislodge the object.
• Check again for signs of breathing.
• If the child is still not breathing, call triple zero (000) and ask for an ambulance. The ambulance service operator will be able to tell you what to do next. You will probably be advised to start expired air resuscitation (mouth to mouth) while waiting for help.
• Do not use the Heimlich manoeuvre (squeezing the abdomen or hitting the child in the abdomen) unless directed to by the ambulance service operator, as this can cause serious damage to organs in the abdomen.

Precautions to prevent children choking

Small children are at risk from choking on food and small items such as buttons or beads. Parents can take many precautions to reduce the risk of their child choking.

The molars (back teeth) are used for grinding and mashing foods. Children don’t start getting their molars until they are somewhere between 12 and 18 months of age, and it may take a further two years or more until all the molars are through and the child is very good at chewing. This means they are vulnerable to choking on hard foods such as raw carrot, chunks of apple, lollies, popcorn or peanuts.

Suggestions to prevent choking include:

• Hard foods should be cooked, mashed, grated or avoided altogether.
• Cut meat into small, manageable pieces for your child, and remove tough skins from sausages and frankfurters.
• Cut food lengthwise to make it narrower.
• Supervise your child while they are eating.
• Explain to your child the importance of eating food quietly and while sitting down.
• Don’t try to feed them if they are laughing or crying.

Remove choking hazards

Parents should be aware of potential choking hazards. Suggestions include:

• Treat any object smaller than a ping-pong ball (such as coins, buttons, marbles and beads) as a possible choking threat. Keep these small objects out of your child’s reach.
• Polystyrene beads, found in beanbags and some stuffed toys, are easily inhaled. Check toys regularly for signs of wear and tear.
• If you spot a potential choking hazard, remove or secure it immediately.
• Only buy toys from reputable manufacturers. Toys should comply with the Australian Standard AS1647.
• Warning labels on toys, such as ‘Not suitable for children under three years’, means that small parts may present a choking hazard. The label doesn’t refer to skill level.
• Keep balloons away from small children. A bitten balloon may burst and send fragments down the child’s throat.
• Older children in the household should be warned not to leave potentially dangerous items near young children.
• Peanuts are a well-known hazard.

First aid courses for treating children

Emergency medical treatment for young children isn’t always the same as for adults, which is why all parents should take a course in paediatric (child) first aid.

Where to get help

• In an emergency, call triple zero (000)
• Emergency department of the nearest hospital
• Your doctor
• Community Information team (formerly Safety Centre), Royal Children’s Hospital Tel. (03) 9345 5085
• Maternal and Child Health Line, Victoria (24 hours) Tel. 132 229
• For first aid training, contact St John Ambulance Australia (Victoria) Tel. 1300 360 455 or Australian Red Cross Tel. 1300 367 428

Things to remember

• Always call triple zero (000) for an ambulance in an emergency.
• Don’t slap a choking person on the back while they are upright – gravity may cause the object to slip further down the trachea (windpipe).
• First aid for choking adults includes back blows and chest thrusts while the person is leaning forward.
• Toddlers are at risk from choking on food and small items such as buttons or beads. Supervise your child at all times when they are eating.

90,000 Shortness of breath, asthma attacks at Angio Line Medical Center. Make an appointment

Shortness of breath occurs when the body cannot cope with the respiratory load. Shortness of breath can be caused by respiratory disorders, lung diseases (bronchitis, pneumonia, vascular diseases, etc. ), cardiovascular diseases, anemia, panic attack, and others.

Dyspnea in case of lung diseases

Occurs when the expiratory flow does not match the inhalation. In this case, it is not difficult to identify a pulmonary disease due to the presence of dry wheezing in the patient.If bronchial disorders are combined with a decrease in the degree of expansion of the lungs, the diagnosis is more difficult.

In the presence of pulmonary pathology, shortness of breath increases with exertion. The position of the body does not affect her. Shortness of breath when speaking indicates a decrease in lung capacity.

Shortness of breath in heart disease

Left gastric failure, heart failure, increased blood pressure in the lungs lead to difficulty breathing.

Dyspnea with heart failure worsens with physical exertion and in the supine position.Short bouts of shortness of breath are common symptoms of arrhythmia.

Other causes of shortness of breath

With a decrease in the level of hemoglobin, a change in the acid-base balance towards an increase and an excess of thyroid hormones in patients, shortness of breath is also observed. But even in these cases, it is motivated by cardiovascular diseases.

Shortness of breath significantly impairs quality of life and morale. If shortness of breath is diagnosed, see your doctor immediately.

Attacks of suffocation

Causes of asthma attacks:

– bronchial asthma,
– laryngeal edema,
– pulmonary edema,
– head and neck injuries,
– foreign bodies entering the respiratory tract,
– panic attack
, etc.

As a rule, asthma attacks are signs of pulmonary or other dangerous diseases. If you have a choking attack, do not panic, be calm and call an ambulance immediately. Relatives and doctors will help you.

90,000 Choking, a description of the disease on the Medihost.ru portal

Choking is an extremely severe expression of shortness of breath, manifested not only in an acute feeling of lack of air, but also in a real fear of death.In some cases, the term “asphyxia” can be used to denote this phenomenon, but strictly speaking in scientific terms, the state of suffocation is a kind of shortness of breath.

A pathological state of asphyxiation can be triggered by a foreign body, lung cancer, bronchial asthma, a tumor of the bronchi, larynx and trachea, pneumonia and pneumothorax. A severe attack of suffocation can provoke cardiovascular diseases, for example, myocardial infarction, heart disease, pericarditis.

Causes of suffocation

Violation of normal functioning of respiration can cause both external and internal pathological processes:

• Stagnation of blood in the pulmonary circulation.
• Cardiac asthma.
• Bronchial asthma, with impaired bronchial patency.
• Bronchial asthma, which caused a disturbance in the functioning of the bronchial tree.
• Diseases of the myocardium, which causes stagnation of blood in the pulmonary circulation.
• Vocal cord edema.
• An attack of panic fear (panic attack).
• Ingress of a foreign body into the respiratory tract of a person.
• Anaphylactic shock.
• Severe obstructive pulmonary disease.
• Pulmonary edema.
• Left ventricular failure, in this case, choking is very similar to a severe attack of coughing. A person wakes up at night from a strong cough and lack of air.

It should be noted that nocturnal painful cough against the background of choking is the most characteristic symptom of left ventricular failure.

Symptoms of suffocation

In some cases, suffocation is the result of obstruction of the airways, through which oxygen ceases to flow and its content in the blood is sharply reduced. It is this condition that is an acute attack of suffocation. In some cases, shortness of breath may not bother the patient for a long time. If asthma attacks occur after strenuous physical work, there are good reasons to suspect that there are problems with the functioning of the respiratory or circulatory system.

If attacks of suffocation disturb the patient at night, this indicates an excessive filling of blood in the lungs. This condition can be triggered by a change in the position of the patient during sleep or by the state of his autonomic nervous system. The overwhelming majority of people who experience attacks of suffocation at night react extremely painfully to them. Patients have tachycardia, excessive sweating, cyanoticity, and noticeable wheezing.

All of the above symptoms are first noted only at the base of the lungs, and then over their entire area.For cases of asthma attacks at night, stagnation of venous pressure is characteristic, patients have swelling of the veins in the neck, enlargement of the liver, edema of the subcutaneous tissue and other signs that are observed in heart failure.

Diagnosis of suffocation

It is necessary to accurately establish the cause of such a phenomenon as suffocation, for this it is necessary to undergo a full examination by a pulmonologist, allergist, cardiologist and psychotherapist.

Treatment of suffocation

Treatment of this disease is possible only under the supervision of a specialist.In case of attacks of suffocation, the doctor should always be in touch. In order for the treatment to bring the expected result, an individual program of therapeutic measures is drawn up for each patient. It takes into account the physiological characteristics of the patient, makes adjustments as necessary, takes into account the factors that provoke the occurrence of asthma attacks. If seizures occur, you need to urgently call an ambulance.

Shortness of breath, choking: what to do, how to treat

Choking is scary.The inability to breathe is unbearable for any living being. Therefore, we empathize so much with those walled up in a wall, buried alive, dying submariners, etc.

There are diseases in which choking is a constant symptom, when people experience choking for no apparent external reason. These diseases include lung and heart diseases such as bronchial asthma, chronic obstructive bronchitis, allergic conditions, pulmonary emphysema, chronic obstructive pulmonary disease, heart failure associated with coronary artery disease, heart defects, cardiomyopathies, hypertension, and many others.

Asphyxiation, as a rule, begins with shortness of breath – with difficulty inhaling or exhaling, or both at the same time.

In order to find out what condition leads to shortness of breath or suffocation, it is necessary to undergo a consultative examination with a therapist, who will prescribe the necessary examination for this problem.

The survey plan must first of all give the answer: which system is affected – cardiovascular, pulmonary, or is it an allergic reaction.
You can get answers to your questions or make an appointment by calling the multichannel phone: (495) 956-91-03

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Symptoms, treatment of bronchial asthma | Allegro

A chronic pathology that affects the respiratory tract and is characterized by periodic attacks is bronchial asthma.The disease becomes more widespread every year. Diseases are susceptible to people of different sex and age. In addition, the hereditary factor plays an important role: if one of the parents suffers from asthma, the probability of developing it in children is about 50 percent, if both parents suffer from pathology, the child will be at risk of developing the disease in 65 percent of cases. With the right therapy, asthma in children often goes away completely, but in adulthood it is a chronic disease that requires constant treatment.

Types of pathology

Depending on the cause of the disease, pathology can be divided into several types. If a patient is diagnosed with bronchial asthma, the doctor’s recommendations will include both therapeutic and preventive measures that can reduce the frequency of attacks.

Pulmonary specialists distinguish between the following types of asthma:

• Allergic, which is often combined with skin diseases and allergic rhinitis.
• Endogenous, the development of which is not influenced by allergens from the external environment.

The first type of pathology is characteristic of childhood and adolescence, it develops in the presence of allergens such as pollen, dust, epidermis of animal skin. Less commonly, food allergens cause asthma. The patient becomes more sensitive to any external stimuli, such as cold air or smoke. Seizures can cause rapid breathing and increased physical activity.

Bronchial asthma: symptoms

The main symptom of pathology is a severe attack of suffocation. An attack, as a rule, has precursors, thanks to which the patient can understand that a severe asthmatic condition will soon begin. Among them:

• intense mucous discharge and continuous sneezing,
• feeling of stiffness and inability to breathe deeply,
• whistling and wheezing when breathing,
• wet cough.

In addition, experts recommend that patients pay attention to certain conditions of the body that can signal the presence of bronchial asthma or the risk of its development.It:

• Recurrent respiratory problems which may be seasonal;
• Allergic reactions of various kinds, eczema;
• Frequent viral diseases affecting the lungs;
• Improvement of well-being when taking anti-allergic drugs.

It is important to be attentive to the listed symptoms, especially in childhood. Timely diagnosed bronchial asthma, the symptoms of which can be seen with the naked eye, lends itself to effective treatment, and the disease is successfully stopped.

How is the disease diagnosed?

The disease is diagnosed by a pulmonologist. On a face-to-face examination, a specialist will not only make an accurate diagnosis, but also determine the stage of pathology. The doctor conducts the following diagnostics:

• Analyzes sounds emitted when tapping the chest;
• Listens to the patient with a phonendoscope;
• Examines the lungs using spirometry;
• Sets the maximum rapid expiratory volume.

In order to identify concomitant pathologies or to clarify the stage of development of the disease, the specialist may additionally prescribe a general blood test, sputum analysis, X-ray and electrocardiography to the patient.

Treatment of bronchial asthma

It should be supervised by an experienced pulmonologist, otherwise serious complications cannot be avoided. Priority recommendations include the mandatory exclusion of any contact with allergens that cause seizures.Where the patient is, there should be no dust, feathers, pollen of plants, animal hair. It is undesirable to use air fresheners, perfumes, and other chemicals sprayed into the air. Compliance with a food diet is of great importance. A diet for bronchial asthma implies the exclusion of foods that can cause allergic reactions: chocolate, honey, nuts, citrus fruits.

Without fail, the patient is prescribed medications that are capable of arresting the syndrome of sudden suffocation by relieving bronchial edema.Mucolytics are used to stimulate sputum discharge. In especially difficult situations, the treatment of bronchial asthma includes hormonal agents.

Prevention of bronchial asthma

Correct prevention of bronchial asthma can be so effective that the patient forgets about the unpleasant manifestations of pathology for a long time. The risk of complications is markedly reduced. Common preventive recommendations include:

• Daily long walks in the fresh air,
• avoid contact with allergens,
• hardening and prevention of upper respiratory tract infections,
• complete rejection of bad habits, primarily from smoking,
• exclusion from everyday life of household chemicals,
• use only hypoallergenic cosmetics,
• adherence to food diet,
• Regular exercise therapy and physical activity.

In the room where a sick person or a person potentially at risk of getting sick is located, it is important to regularly do wet cleaning, wash bed linen weekly at high temperatures, use synthetic pillows and blankets, and refuse carpets and upholstered furniture in the interior.

The main task of our clinic is to diagnose the problem in a timely manner, provide the correct prophylaxis and prescribe effective treatment. To make an appointment with a pulmonologist in our clinic with a diagnosis of bronchial asthma or suspicion of it, call or contact us via the feedback form.The operator will make an appointment with a specialist at the earliest convenient time. We care about your health!

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SPb GBUZ “City polyclinic No. 114”

Acute heart failure (AHF) is a serious pathological condition that develops in patients with various heart diseases and hypertension. This is one of the most frequent reasons for calling an ambulance and hospitalization of patients, as well as mortality of the population of our country and the whole world.
The main manifestations (symptoms) of acute heart failure are:
– heavy, frequent (more than 24 per minute) noisy breathing – shortness of breath, sometimes reaching a degree of suffocation, with predominant difficulty breathing and a clear increase in shortness of breath and cough in a horizontal position. Sitting or reclining with a high headboard eases the patient’s condition;
– often during breathing, moist squelching rales / sounds are heard, interrupted by coughing, in the terminal stage, breathing takes on the character of bubbling with the appearance of foam at the patient’s mouth;
– a characteristic sitting posture of a patient resting his knees with straight arms.
Acute heart failure can develop very quickly and within 30 – 60 minutes. lead to the death of the patient. In most cases, it takes 6-12 hours or more from the first clinical signs to severe manifestations of AHF, however, without medical assistance, the vast majority of patients with AHF die.

First aid measures:
When patients with hypertension or heart disease (but not lungs or bronchi) develop the above symptoms of AHF, it is necessary: ​​
– call an ambulance;
– give the patient a sitting position, preferably in a chair with armrests on which he can lean and include the intercostal muscles in the act of breathing;
– to provide physical and psycho-emotional peace and fresh air by ventilating the room;
– lower your legs into a large container (basin, tank, bucket, etc.) with hot water;
– in extremely severe cases, tourniquets are applied to the legs in the groin area, squeezing the superficial veins, but not deep arteries, which reduces blood flow to the heart and thereby facilitates its work.
If the patient or the person providing first aid has experience, the use of nitroglycerin is prescribed in a dose of 0.4 (0.5) mg (inhalation into the oral cavity is performed under the root of the tongue, the tablet / capsule is placed under the tongue, the capsule must be previously bite through, do not swallow).If the patient’s well-being improves after the application of nitroglycerin, it is used again, every 5 to 10 minutes. before the arrival of the ambulance team. In the absence of improvement in the patient’s well-being after the use of nitroglycerin, it is no longer used.
Attention !!!!!!! A patient with AHF is strictly forbidden to get up, walk, smoke, drink water and take liquid food until the special permission of a doctor; you can not take nitroglycerin with blood pressure less than 100 mm Hg. Art. with severe headache, dizziness, acute visual impairment, speech or coordination of movements.
All patients with essential hypertension or heart disease with shortness of breath and edema on the legs should discuss with their doctor what drugs should be taken when AHF develops, clearly write down their names, dosage and time sequence (algorithm) of their administration, and also check with the doctor. under what manifestations of the disease it is necessary to urgently call an ambulance. Each such patient needs to form an individual first aid kit for AHF and have it with him at all times.

90,000 Shortness of breath – causes, symptoms and treatment

Shortness of breath (dyspnea) – a painful feeling of lack of air, in extreme expression takes the form of suffocation.

If shortness of breath occurs in a healthy person against the background of physical exertion or severe psychoemotional stress, it is considered physiological. It is caused by the increased demand of the body for oxygen. In other cases, shortness of breath is caused by any disease and is called pathological.

According to the difficulty of the inhalation or exhalation phase, dyspnea is distinguished as inspiratory and expiratory, respectively. A variant of mixed dyspnea with limitation of both phases is also possible.

There are several types of shortness of breath. Shortness of breath is considered subjective if the patient feels shortness of breath, dissatisfaction with inhalation, but this cannot be measured and there are no factors of its occurrence. Most often it is a symptom of hysteria, neurosis, chest sciatica. Objective shortness of breath is characterized by a violation of the frequency, depth of breathing, the duration of inhalation or exhalation, as well as increased work of the respiratory muscles.

Causes of shortness of breath

Shortness of breath can be caused by a long list of conditions. First of all, it is:

• respiratory system diseases,
• pathology of the cardiovascular system,
• blood diseases,
• endocrine system disorders and other factors.
  

Diseases with shortness of breath

In diseases of the respiratory system, shortness of breath may be the result of an obstruction in the airways or a decrease in the area of ​​the respiratory surface of the lungs.

Obstruction in the upper airways (foreign body, swelling, accumulation of phlegm) makes it difficult to inhale and pass air to the lungs, thereby causing inspiratory dyspnea. A decrease in the lumen of the end sections of the bronchial tree – bronchioles, small bronchi with inflammatory edema or spasm of their smooth muscles prevents exhalation, causing expiratory dyspnea. In the case of narrowing of the trachea or a large bronchus, shortness of breath takes on a mixed character, which is associated with the limitation of both phases of the respiratory act.

Dyspnea will also be mixed due to inflammation of the lung parenchyma (pneumonia), atelectasis, tuberculosis, actinomycosis (fungal infection), silicosis, pulmonary infarction or its compression from the outside by air, fluid in the pleural cavity (with hydrothorax, pneumothorax). Severe mixed shortness of breath up to choking is observed with pulmonary embolism. The patient takes a forced sitting position with support on his hands. Choking in the form of a sudden attack is a symptom of asthma, bronchial or cardiac.

With pleurisy, breathing becomes shallow and painful; a similar picture is observed with chest injuries and inflammation of the intercostal nerves, damage to the respiratory muscles (with poliomyelitis, paralysis, myasthenia gravis).

Shortness of breath in heart disease is a fairly frequent and diagnostic symptom. The cause of shortness of breath here is a weakening of the pumping function of the left ventricle and blood stagnation in the pulmonary circulation.

By the degree of shortness of breath, one can judge the severity of heart failure.At the initial stage, shortness of breath appears during physical exertion: climbing stairs more than 2-3 floors, walking uphill, against the wind, moving at a brisk pace. As the disease progresses, it becomes difficult to breathe even with slight exertion, when talking, eating, walking at a calm pace, lying horizontally. In the severe stage of the disease, shortness of breath occurs already with minimal exertion and any actions, such as getting out of bed, moving around the apartment, tilting the body, entail a feeling of lack of air.In the final stage, shortness of breath is present at all at rest.

Attacks of severe shortness of breath, suffocation that occur after physical, psycho-emotional stress or suddenly, often at night, during sleep are called cardiac asthma. The patient takes a forced sitting position. Breathing becomes noisy, bubbling, audible from a distance. There may be a release of foamy sputum, which indicates the onset of pulmonary edema, with the naked eye, the participation of auxiliary muscles in the act of breathing, retraction of the intercostal spaces is noticeable.

In addition, shortness of breath in combination with chest pains, palpitations, interruptions in the work of the heart can be a sign of acute myocardial infarction, rhythm disturbances (paroxysmal tachycardia, atrial fibrillation) and is caused by a sharp decrease in heart function, decreased perfusion and oxygen supply to organs and tissues.

A group of blood diseases, one of the symptoms of which is shortness of breath, includes anemia and leukemia (tumor diseases). Both are characterized by a decrease in the level of hemoglobin and erythrocytes, the main role of which is oxygen transport.Accordingly, oxygenation of organs and tissues worsens. A compensatory reaction arises, the frequency and depth of breathing increase – thus the body begins to consume more oxygen from the environment per unit of time.

The simplest and most reliable method for diagnosing these conditions is a complete blood count.

Another group – endocrine (thyrotoxicosis, diabetes mellitus) and hormone-active diseases (obesity).

In case of thyrotoxicosis, the thyroid gland produces an excessive amount of hormones, under the influence of which all metabolic processes are accelerated, metabolism and oxygen consumption increase. Here, shortness of breath, as in anemia, is of a compensatory nature. In addition, high levels of T3, T4 enhance the work of the heart, contributing to rhythm disturbances such as paroxysmal tachycardia, atrial fibrillation with the consequences mentioned above.

Dyspnea in diabetes mellitus can be considered as a consequence of diabetic microangiopathy, leading to impaired trophism, oxygen starvation of cells and tissues.The second link is kidney damage – diabetic nephropathy. The kidneys produce a hematopoietic factor – erythropoietin, and with its deficiency anemia occurs.

In obesity, as a result of the deposition of adipose tissue in the internal organs, the work of the heart and lungs is hampered, the excursion of the diaphragm is limited. In addition, obesity is often accompanied by atherosclerosis, hypertension, this also entails a violation of their function and the occurrence of shortness of breath.

Shortness of breath up to the degree of suffocation can be observed with all sorts of systemic poisoning.The mechanism of its development includes an increase in the permeability of the vascular wall at the microcirculatory level and toxic pulmonary edema, as well as direct damage to the heart with impaired function and stagnation of blood in the pulmonary circulation.

How is shortness of breath treated?

It is impossible to eliminate shortness of breath without understanding the cause, establishing the disease that caused it. For any severity of shortness of breath, you need to see a doctor for timely assistance and prevention of complications.Doctors whose competence includes the treatment of diseases with shortness of breath are therapist, cardiologist, endocrinologist.

Specialists of AVENUE medical centers will answer in detail and in an accessible form all questions related to your problem and will do everything to solve it.

90,000 IF THE DOG SLOWS – WHAT TO DO?

A piece of food or a bone stuck in the throat of an animal may well cause suffocation, and the life of a pet depends only on your speed and professionalism.

You may not see how the fatal event happened, but knowing the main symptoms of suffocation, you will immediately understand that the pet needs urgent help:
– frequent vomiting, in most cases unsuccessful.
– inability to swallow not only food, but even water. Often, the dog cannot even swallow its own saliva, which simply flows out of the mouth.
– attacks of coughing, shaking the entire body of the pet.
– severe intestinal cramps, seething, bloating and other symptoms of intestinal obstruction that occur if a foreign object has entered the stomach.
– The head and neck are extended and lowered.
– The dog rubs its muzzle and neck with its paws, trying to get rid of the interfering object. All this is accompanied by panic attacks and yelping.
– wheezing and holding of breath, redness and subsequent cyanosis of the mucous membranes.
– inability to stay on your feet.
– Loss of consciousness WHAT TO DO If you notice one or more of these symptoms, watch your pet closely. In most cases, if the foreign body is not stuck very deeply, the animal itself will cough it up or it will come out with vomit.The situation becomes life threatening if the dog is small or the stuck piece is large, how do you recognize a dangerous situation? First of all, the cough in this case is not productive, but after a while it turns into wheezing and hissing, the dog cannot breathe air, its mucous membranes turn blue.
At this moment, the count goes literally for minutes, and it depends only on the owner and his composure whether his pet has a chance for life. Here’s what to do first: Try to induce a swallowing motion in the dog.This can be done by offering a small bite of a treat, or by massaging the throat, and sit the dog in front of you with your legs firmly in place.
Open the mouth of the animal and look inside.
To improve visibility, ask the assistant to shine a flashlight into the animal’s mouth and carefully examine the mucous membranes, paying attention to any foreign objects in the throat, such as bones or pieces of sticks. If you notice a foreign object, try to reach it with tweezers or fingers. Be extremely careful not to push it deeper.The ingestion of dry food in the windpipe is another common cause of death in dogs. If your dog chokes on dry granules, lift it up by its hind legs and shake it sharply so that the foreign objects fly out on its own. After removing the stuck object, make sure that the condition of the pet returns to normal.