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Patient complaints of swallowing difficulty and their possible physiologic counterparts

Patient complaints of swallowing difficulty and their possible physiologic counterparts
Patient's complaint Physiological impairment
Choking on fluids

Poor tongue control for oral manipulation

Impaired laryngeal closure

Delayed onset of pharyngeal swallow
Protracted meal times

Weak chewing

Diminished endurance
Nasal regurgitation of fluids Incompetent velopharyngeal mechanism
Difficulty getting swallow started Reduced oral and hypopharyngeal sensation
Dry mouth Reduced or impaired saliva production
Solids caught in throat

Weak tongue-driving force

Impaired laryngeal excursion fails to open upper esophageal segment
Regurgitation or emesis after swallowing Poor esophageal motility or esophageal obstruction
Sour taste in mouth after eating Gastroesophageal reflux
Pain on swallowing Esophagitis, mucositis, esophageal obstruction
Excessive drooling Reduced frequency or efficiency of swallowing
Food sticking in thoracic or chest region Poor esophageal motility or obstruction
Reprinted by permission of Oxford University Press, USA. Dahlin CM, Cohen AK, Goldsmith T. Dysphagia, Xerostomia, and Hiccups. In: Oxford Textbook of Palliative Nursing, 3rd ed, Ferrell BR, Coyle N (Eds), Oxford University Press 2010. Copyright © 2010. www.oup.com.
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