Kimber
dx: asthma, anxiety disorder, fibromylagia, suspected Lupus or RA
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.
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.....
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
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.....
~elisha~
Kimber
dx: asthma, anxiety disorder, fibromylagia, suspected Lupus or RA
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
Psalm 3:5;6;7;8
Post Edited (Neurotransmissing) : 3/31/2006 4:57:12 PM (GMT-7)
dx: asthma, anxiety, inflammatory arthritis, suspected Lupus or RA
~ 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.
~ Living in the Solution Eliminates the Problem ~
Post Edited (Neurotransmissing) : 4/29/2006 5:22:07 PM (GMT-6)
Cyndi
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
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
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