Swallowing disorders, which are also known as dysphagia, are a common complication that is seen in people who had a stroke-paralysis. Swallowing process in stroke patients necessitates a coordinated effort of muscles and nerves, and when the paralysis disrupts the delicate balance, it may lead to significant problems in eating and drinking. In this article, we have compiled the causes of swallowing disorders in Stroke patients and their effects on overall health.
One of the main causes of swallowing disorders in stroke patients is the damage on the areas of the brain responsible for coordinating swallowing functions. When a stroke occurs, the blood flow to the brain is disrupted, and this leads to oxygen insufficiency and damage on the important areas such as the brain stem and cranial nerves.
Swallowing function takes place in four stages: The oral preparatory stage, the oral transit stage, the pharyngeal stage and the esophageal stage.
These areas play a quite important role in controlling the movements required for safe and effective swallowing. The severity of dysphagia generally depends on the size and location of the stroke; it causes a more profound effect on swallowing function in the areas of larger Stroke – paralysis.
Another important factor which contributes to swallowing disorders in the patients who had a stroke is muscle weakness. Weakness in the muscles of mastication and swallowing can be a result of the Stroke or of a prolonged immobility during recovery.
This weakness may lead to problems in transferring food from the mouth to the esophagus, this may increase the aspiration risk (food or fluid entrance in the airway), and this may lead to pneumonia and other respiratory complications.
Sensory loss is a factor which is known less but quite important in post- stroke swallowing impairment. The persons who had a stroke may experience a reduced ability to feel and react to sensations in the mouth and throat, and this makes to coordinate the swallowing reflex difficult. This sensory insufficiency may contribute to the risk of aspiration by leading to retarded or inadequate responses during swallowing.
In addition to the physical factors, cognitive impairments may also heighten swallowing disorders in paralysis patients. Problems such as impairment in attention, memory and executive functioning, may lead to incorrect swallowing techniques by affecting the ability to follow instructions during eating, and bring an increased risk of choking among the other risks.
Tackling the swallowing disorders in stroke patients is important not only for nutritional and hydration needs, but also for the prevention of the complications which threaten life potentially.
Speech-language therapists play a crucial role in the rehabilitation process by working to improve muscle strength, coordination and sensory awareness with patients. The strategies are determined according to the needs of the patients and may include modified diets to enhance safety during eating, exercises and speech therapy methods.
The causes of swallowing disorders in stroke-paralysis patients are manifold by involving both physical and cognitive factors. Understanding these causes is quite important to develop effective rehabilitation strategies and improve the general life quality of the patients who had a stroke.
Intervention in time, comprehensive physical therapy and rehabilitation, and support of healthcare professionals may reduce the impact of swallowing impairment significantly and support individuals to regain their ability to eat and drink in a safe manner.
This article has been prepared and approved by the Medical Editorial Board of the Istanbul Rehabilitation Academy.
