Swallowing problems

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Kimber
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Date Joined Jun 2005
Total Posts : 1852
   Posted 3/29/2006 7:07 PM (GMT -7)   
Does anyone have any swallowing issues related to MS? Does it seem to be related to anything in particular like food, drink, (hot or cold) or just normal swallowing. What have you found that is helpful. Trying to gain some insight into this symptom. Thanks for all your help!!

Kimber
dx: asthma, anxiety disorder, fibromylagia, suspected Lupus or RA
     Caregiver to hubby with PPMS
 
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shellypoo
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Date Joined Dec 2005
Total Posts : 896
   Posted 3/29/2006 8:14 PM (GMT -7)   
Hi,
I, too have been experiencing some strange swallowing problems and read this article:
Multiple Sclerosis:
Speech and Swallowing Problems

People with MS often have swallowing difficulties. In many cases, they are associated with speech problems as well.

What Causes Speech and Swallowing Problems in People With MS?

Like other symptoms of MS, if you're experiencing swallowing or speech difficulties, it's because you have an area of damaged nerves that normally aid in performing these tasks.

Locating the damaged areas responsible for the speech problem is often difficult. Many areas in the brain, especially the brainstem, control speech patterns. Thus, lesions -- damaged areas -- in different parts of the brain can cause several types of changes in normal speech patterns. They range from mild difficulties to severe problems that make it difficult to speak and be understood.

What Are the Symptoms of a Swallowing Problem?

  • Coughing or choking when eating
  • Feeling like food is lodged in the throat
  • Unexplained recurrent lung infections (pneumonia)
  • Otherwise unexplained malnutrition or dehydration

When swallowing difficulties are present, food or liquids that you eat may be inhaled into the trachea (windpipe) instead of going down the esophagus and into the stomach. Once in the lungs, the inhaled food or liquids can cause pneumonia or abscesses. Because the food or drink is not reaching the stomach, a person may also be at risk for malnutrition or dehydration.

How Are Swallowing Problems Diagnosed?

Initially, your doctor will ask you many questions about the nature of your problem and perform a physical exam, paying attention to the function of your tongue and swallowing muscles.

Occasionally, your doctor may recommend that you get a test called a modified barium swallow. This is a special imaging procedure where you drink or eat contrast material of different consistencies -- solid, thick liquid, and thin liquids after which a machine takes pictures tracing the path of the contrast material. Thus the precise location and manner of the swallowing problem can be identified.

How Are Swallowing Problems Treated?

A speech therapist (or speech and language pathologist) usually treats swallowing problems. Treatment typically consists of changes in diet, positioning of the head, exercises, or stimulation designed to improve swallowing. In very severe cases that do not respond to these measures, feeding tubes may be inserted directly into the stomach to provide the necessary fluids and nutrition.

Here are some tips that may make swallowing easier:

  • Sit upright at a 90-degree angle, tilt your head slightly forward, and/or remain sitting or standing upright for 45 to 60 minutes after eating a meal.
  • Minimize distractions in the area where you eat. Stay focused on the tasks of eating and drinking. Do not talk with food in your mouth.
  • Eat slowly. Cut your food into small pieces and chew it thoroughly. Do not try to eat more than 1/2 teaspoon of your food at a time.
  • You may need to swallow two or three times per bite or sip. If food or liquid catches in your throat, cough gently or clear your throat, and swallow again before taking a breath. Repeat if necessary.
  • Concentrate on swallowing frequently. It may help to alternate a bite of food with a sip of liquid. If you have difficulty sucking liquid all the way up a straw, cut the straw down so that there is less distance for the liquid to travel.
  • Change the temperature and texture of liquids (make the liquids colder, try carbonated beverages).
  • Drink plenty of fluids. Periodically suck on Popsicles, ice chips, lemon ice, or lemon-flavored water to increase saliva, which will increase swallowing frequency.
  • If chewing is difficult or tiring, minimize (or eliminate) foods that require chewing, and eat more soft foods. Puree your foods in a blender.
  • If thin liquids cause you to cough, use a liquid thickener. You can also substitute thin liquids with thicker liquid choices such as nectars for juices and cream soups for plain broths.
  • When taking medication, crush your pills and mix them with applesauce or pudding. Ask your pharmacist for recommendations on which pills should not be crushed and which medications can be purchased in a liquid form.


Michelle ><>
 God formed us; sin deformed us; Christ transforms us.


uppitycats
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Date Joined Jun 2005
Total Posts : 2135
   Posted 3/30/2006 7:43 AM (GMT -7)   

Good article!

Another thing that can happen that I didn't see here -- and what causes me problems: esophogeal spasms. The esophogus can close up, not allowing food to continue down into the stomach.  This can be very painful, and if it happens while eating (and food will trigger it), I'll throw up. 

Most of the remedies for the spasm are what are listed here for other problems -- eat slowly, drink fluids, avoid eating dry foods without liquid (late night popcorn in bed is a no-no!). And I find that if I am talking and eating at the same time, that'll cause problems, too.

The spasms are part of the same spasm thing for any other muscle spasms. So far I've not found any meds that have helped.

 


...I am not a doctor, nor health professional, and don't pretend to be one, here.....


shellypoo
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Date Joined Dec 2005
Total Posts : 896
   Posted 3/30/2006 7:57 AM (GMT -7)   
Uppity...bless you're heart...throwing up???  That must be awful!!  sad
 
 I had my swallowing checked a couple of years ago (just by an endoscopy) and they couldn't find anything.  Mine is usually when I'm drinking something and it's like it gets caught in my throat.  It's scary, makes me feel like I can't breath, I've learned to be real calm and take slow breaths and it will realx enough to go down.  But lately it's happening with icecream, too and some other things but I can't remember what they were.
:-)  

Michelle ><>
 God formed us; sin deformed us; Christ transforms us.


rhondab
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Date Joined Mar 2006
Total Posts : 2146
   Posted 3/30/2006 8:27 AM (GMT -7)   
I've had that prob for about 3 years or more now...but didn't see it explained in anything as Uppitiycats did. Thanks. It clears up my question about it. I can eat anything solid..not ice cream so far thank goodness...and it will sometimes lodge in my throat..as in my chest sorta...and won't go down. No amount of liquids will help. In fact..liquids just sit there on top of it and make u feel like u'r drowning if u continue...which is u'r natural response. I have to sit real still and up straight to allow it time to decide it's time to go down and eventually it will. The first time it happened i was so scared. It's still scary, but now i've figured out what to do to help myself. So far no throwing up. I'm really sorry u'r to that point Uppitycatts. I hope that will improve as well as Michelle having probs with ice cream. This is really good info to have...i haven't told my neuro about this cause i thought it was totally unrelated per what i've read...but as i've seen time and time again...it IS likely related. U guys can explain things so well!!! :))

Kimber
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Date Joined Jun 2005
Total Posts : 1852
   Posted 3/30/2006 1:28 PM (GMT -7)   
Great article Michelle, thank you!

Uppity, thanks for the additional info and I'm sorry that you are having such severe spasms as you are :(

I think hubby might be having spasms, anyone experience any type of choking sensation along with this? Like things going down the wrong pipe?

Kimber
dx: asthma, anxiety disorder, fibromylagia, suspected Lupus or RA
     Caregiver to hubby with PPMS
 
Let Healing Well continue to help others, click link for details
 

uppitycats
Veteran Member


Date Joined Jun 2005
Total Posts : 2135
   Posted 3/31/2006 5:17 AM (GMT -7)   
Yes...the spasms can cause choking. I'm not always sure if it's the spasms that cause the vomiting, or the choking-down-the-wrong-pipe thing.

In truth, too, food CAN be "going down the wrong pipe" -- aspiration into the lungs is never a good thing...that's a primary cause of pneumonia...
...I am not a doctor, nor health professional, and don't pretend to be one, here.....


els
Veteran Member


Date Joined Oct 2005
Total Posts : 4031
   Posted 3/31/2006 9:14 AM (GMT -7)   
I too have this problem with swallowing.  I have had several swallow studies done and get chest x-rays done to guard against Pneumonia as I have aspirated fluids into my lungs.  Also, antibiotics help to insure against infection.  It is pretty painful to do that.
~elisha~ 
 
ways to help support healing well:
 
 


Kimber
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Date Joined Jun 2005
Total Posts : 1852
   Posted 3/31/2006 12:59 PM (GMT -7)   
Thanks ladies, the thought of getting pneumonia is a bit frightening. We'll be watching it closely and mention it to the doc.

Kimber
dx: asthma, anxiety disorder, fibromylagia, suspected Lupus or RA
     Caregiver to hubby with PPMS
 
Let Healing Well continue to help others, click link for details
 

Neurotransmissing
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Date Joined Dec 2005
Total Posts : 952
   Posted 3/31/2006 4:45 PM (GMT -7)   
WOW!!! Michelle ROCKS again!!

I have swallowing troubles, mine seem to be "emotionally based." I never attributed it to MS, interesting. Strange maybe, but when I'm upset, my throat refuses to cooperate; I don't try, fearing I may choke! It doesn't happen often at all, only when there are "extreme" things happening, (I have a son that's 21, and another that's 14, so there's a sign. LOL)

~ Cindy
 
p.s.  I just came back and reviewed this article again.  I definitely have the voice problems!  Michelle, you know that.  I thought it was one of those "less common" side-effects of the Rebif; but I guess not, it's not getting any better.  It comes and goes, but mostly stays.  Like something has happened to my voice box.
 
sad
Psalm 3:5;6;7;8
"Trust in the LORD with all your heart and lean not on your own understanding;"
"in all your ways acknowledge Him, and He will make your paths straight."
"Do not be wise in your own eyes; fear the LORD and shun evil."
"This will bring health to your body and nourishment to your bones."

Post Edited (Neurotransmissing) : 3/31/2006 4:57:12 PM (GMT-7)


Kimber
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Date Joined Jun 2005
Total Posts : 1852
   Posted 4/29/2006 4:46 AM (GMT -7)   
bumping up for sjk
dx: asthma, anxiety, inflammatory arthritis, suspected Lupus or RA
     Caregiver to hubby with PPMS
 
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Neurotransmissing
Veteran Member


Date Joined Dec 2005
Total Posts : 952
   Posted 4/29/2006 2:08 PM (GMT -7)   
I have this problem from time-to-time. I have trouble when I'm very upset. Other than those times, I haven't noticed it. I think mine's more emotional, perhaps a little "enhanced" by the MS, but probably not due to it.

~ Cindy

p.s.  DUH!!  I see I already posted this long ago (above).  The voice problems have gone away for the most part, at least for now.

eyes  


~ Living in the Solution Eliminates the Problem ~

Post Edited (Neurotransmissing) : 4/29/2006 5:22:07 PM (GMT-6)


sjk
Regular Member


Date Joined Apr 2006
Total Posts : 296
   Posted 5/1/2006 4:07 PM (GMT -7)   
Kimber, thanks for bumping this up.  The article is really helpful! 

Kimber
Veteran Member


Date Joined Jun 2005
Total Posts : 1852
   Posted 1/8/2007 7:51 PM (GMT -7)   
Had some discussion in chat on this subject, bumping up again for those folks interested :-)
 
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whtedragons78
Regular Member


Date Joined Jun 2006
Total Posts : 74
   Posted 1/18/2007 11:57 PM (GMT -7)   
well im just silly, or confused hehehe i just figured out what the "bump up" means hahahahaha, oops i better not laugh too hard or i'll wet my pants. But ive noticed some lately not all the time but a few times a month about the swallowing issue. Sometimes its in the middle of the night, like i cant swallow my on spit. and last week i was eating a sandwich, which ive done 1,000's of times but i could swallow, but it felt like it was lodged just below my neck. Id swallow my bite, then swallow again and be thinking ok nothing in there it already went down, but why do i "think" i still feel it. so i took another bite and swallowed to ck. Then i started thinking ok stop you goof, they'll find you with your face all purple and a mouth full of turkey sandwich. I stopped eating my sandwich and just started watching tv and about 30 mins went by and it was mostly gone. Guess just another MS surprise.
Cyndi
Mother has MS, diagnosed 10 yrs ago.
Diagnosed with spastic colon in 2000.
Diagnosed with RRMS Sept 06
Provigil 100mg, Copaxone


booboobum
Regular Member


Date Joined Jan 2007
Total Posts : 135
   Posted 1/19/2007 7:04 AM (GMT -7)   
I also have swallowing problems but until reading this thread never really associated it with an MS symptom. I'm starting a symptom journal as suggested by the great folks here but my problem is that I don't necessarily know what a symptom may or may not be. So, I guess I'll just write down anything that doesn't feel normal? Geez - my journal is going to be quite lengthy!!!!!!!!
migraines since 1974; septic hip - 1999 with birth of daughter ; hip replacement 9/2003; MS limbo since 3/2004; dx IBS - 5/2005;dx acid reflux - 11/2006; dx compressed L4-5 and T 7-8 - 5/2006; dx RLS - 9/2006
Clonopin, hydrocodone, Butalbital, prevacid and anything else that helps!


rhondab
Veteran Member


Date Joined Mar 2006
Total Posts : 2146
   Posted 1/19/2007 2:15 PM (GMT -7)   
Hey Booboobum

That's exactly what u do...write down anything that's not normal for u. Also, as u read here and other places u'll begin to see and realize things u thought were normal, but weren't happening to others...but u accepted them as 'just something that happens'. We've all done that...me many times...so i suspect u may have too. This swallowing thing is a good example. I have probs that have increasingly gotten worse and i now realize this isn't truely normal for people. I accept this as a symptom and have it in my journal. Anything like this...new or old...that u find has been around with u and given u probs...but u've had no answers to...can be a symptom u should address with u'r doc. Not every little twitch is a symptom, but u know u'rself well enuf to distinguish that. Don't worry about u'r journal being lengthy. If u'd like u can do as i try to do. Before an appt i go thru my journal and try to just note any changes i've seen or any new symptoms i've had. I take that shorter note with me into my appt and that's what i go over with my doc. That eliminates the tedious analyzing or skimming and possibly missing something important. I hope u'r jouranaling goes well. U'r doing great...keep reading and comparing. For me, once i found this site and was able to see other's interpretation of how things felt and acted i was able to then communicate my own symptoms in a much more articulate way. Sometimes u just don't know how to describe things...or if things are really part of the whole picture...so keep reading and hopefully it'll help u along u'r way.
rhonda
Co-Moderator, MS Forum
 
*~*Sometimes the Lord calms the storm. Sometimes He lets the storm rage and calms His child.*~*


booboobum
Regular Member


Date Joined Jan 2007
Total Posts : 135
   Posted 1/20/2007 6:14 PM (GMT -7)   
Rhonda
You are awesome! This is so true - since I found this site, I have been able to connect. I do have some cognitive issues and cant' always find the right word or description or definition for what I'm experiencing and reading the threads has certainly helped.
migraines since 1974; septic hip - 1999 with birth of daughter ; hip replacement 9/2003; MS limbo since 3/2004; dx IBS - 5/2005;dx acid reflux - 11/2006; dx compressed L4-5 and T 7-8 - 5/2006; dx RLS - 9/2006
Clonopin, hydrocodone, Butalbital, prevacid and anything else that helps!


shellypoo
Veteran Member


Date Joined Dec 2005
Total Posts : 896
   Posted 1/31/2007 1:58 PM (GMT -7)   
Bump for snowdog!
Michelle ><>
Co-Moderator MS forum
 
Happiness is not a destination but a day-to-day journey..

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