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Did you know dysphagia is often under recognised in people with COPD?
As part of our Medical Spotlight series, here we look at why people with COPD can suffer from swallowing disorders
Chronic Obstructive Pulmonary Disease, known as COPD, is the name used to describe a number of lung related conditions including emphysema and chronic bronchitis. COPD causes inflammation of the airways, resulting in them becoming narrower and producing mucous, making it harder for air to get in and out of the lungs. The most common cause of COPD is smoking. It is a long term condition and over time can affect the whole body. Symptoms of COPD include shortness of breath, wheezing, chronic cough, mucous production and swallowing difficulties.
Swallowing and breathing are both complex processes,involving the co-ordination of many muscles and nerves. When we swallow, we briefly hold our breath as this allows the airway to close and prevents food and drinks going down the wrong way (aspiration), which can lead to chest infections and choking. For those with COPD who have breathing problems, it can become difficult to co-ordinate this almost automatic process of breathing and swallowing while eating and drinking. This lack of co-ordination can be compounded by patients becoming short of breath during meals, as they must hold their breath each time they swallow. Swallowing difficulties or dysphagia may result from this lack of co-ordination of breathing and swallowing during mealtimes. Dysphagia is under recognised in patients with COPD. 1 This may be due to the fact that it may be hard to tell the difference between a patient’s usual chronic cough compared to coughing due to food or drink going down the wrong way. 1
One way to manage swallowing difficulties that occur as a result of COPD is to modify the texture of foods and thickness of fluids. Thickening food and fluids slows their movement in the mouth and down the throat, giving more control and time to swallow. A speech and language therapist (SLT) will advise if a change to the texture of food and thickness of fluids is required, or if there are any other strategies that can be used to minimise the risk of aspiration.
1. http://lungfoundation.com.au/wp-content/uploads/2014/02/16.-COPD-and-swallowing.pdf [Accessed 28.6.16]
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