Swallowing

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Anonymous
Posted: Sun Oct 21, 2007 1:14 pm Post subject: swallowing

Hello! Why can't people with PD swallow properly? Are the muscles too stiff or are they too weak? If it is weakness, is weakness found in other parts of the body from PD or is it just that the brain doesn't signal the muscles to move? Many thanks for being such a wonderful resource.
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Dr. FernandezJoined: 20 Jan 2007Posts: 90
Posted: Tue Oct 23, 2007 10:12 pm Post subject:

The answer to your question is complex. Some form of swallowing abnormality is reported in up to 95% of patients with PD, depending on the method of assessment. However, dysphagia (problem in swallowing) can often be unrecognized or underestimated by patients. The severity of dysphagia may not correspond to the duration of PD or severity of other motor symptoms All "stages" of swallowing function can be affected in patients with PD including the oral, pharyngeal, and esophageal stages. Oral stage deficits may include drooling, increased oral transit time, and premature spillage of food. The pharyngeal stage function may be remarkable for a pharyngeal swallow delay, the presence of pharyngeal residue after the swallow, and aspiration (when the food goes down the wrong pipe). Although dysphagia is common in PD, it rarely is severe enough to require an alternative means of nutritional support. However, gastrostomy may be considered for some patients as an efficient means to provide additional nutritional support. In some situations, oral intake may continue with the presence of a gastrostomy tube The cause of swallowing problems in PD is complex. It appears to be related to changes in the interaction between the basal ganglia (the primary group of cells affected in PD) and cells all over the brain and brainstem. There can be problems with stiffness and slowness of the swallowing muscles, coordination problems and even sensory changes that contribute to this problem. A swallowing evaluation, sometimes with a barium swallow test may reveal which part of the swallowing action is affected. Based on this, appropriate therapy may be recommended. Typically, PD medications don't work reliably in improving swallowing function in PD. Yours,_________________Hubert H. Fernandez
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Anonymous
Posted: Wed Oct 24, 2007 2:55 am Post subject:

Wow! Thank you so much for your thoughtful response. Best regards.
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Wed Oct 24, 2007 7:27 am Post subject:

Thank you and feel free to keep asking questions!_________________Michael S. Okun, M.D.
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