11 Myths about Dyspagia -- Part Two

In a recent post, we examined 5 common myths about dysphagia.  In this edition, we will introduce myths 6 through 11.MYTH 6: Runny nose is an indication of aspiration: Interestingly, some of the geriatric population we work with might present with a runny nose, ESPECIALLY when eating and not otherwise. It used to be considered an indicator of dysphagia; however it is often a condition called gustatory rhinitis which results in this symptom and apparently has nothing to do with swallow mechanism.MYTH 7: Coughing = Aspiration/penetration: A person can cough or throat clear due to multiple reasons including Laryngopharyngeal reflux (LPR) and not just aspiration/penetration.  A trained clinician need to perform a comprehensive examination to assess the presence or absence of dysphagia.MYTH 8: Straws cause aspiration  A straw is a definite NO for most people having difficulty swallowing liquids: Recommendation of straws is patient based. I personally have had lot of patients with dementia who do better with straw due to the sucking reflex improving the swallowing.MYTH 9: It’s not Right Lower Lobe (RLL) pneumonia, so he/she probably did not aspirate: Pneumonia developed due to aspiration does not always present in the RLL. The location of infiltrate does not have to be on the right side all the time. Right is more prone because of its anatomical structure, however infiltration may also be influenced by a persons position. Distribution of aspiration depends upon the positioning of the patient during the event.MYTH 10: Tube feeding prevents aspiration: Often times people assume that if an individual in no longer eating (NPO) and they are on a tube feeding for nutrition and hydration that that person is no longer at risk of aspiration.  In fact, tube feedings do not necessarily reduce a patient’s risk for aspiration.  Tube feedings can be refluxed and then aspirated.MYTH 11: Objective evaluations are used to determine only the presence or absence of aspiration:  Objective evaluations give much more valuable information than just letting us know the presence or absence of aspiration/penetration. It lets us know the pathophysiology which in turn helps us to develop customized goals to restore swallow function.  We can assess different consistencies, posture modifications and other compensatory strategies to identify the most appropriate diet and the future course of therapy.Thanks for reading.  I hope you enjoyed and would love to hear your thoughts.  Please use the comment box below.About the Author:Ranjini Rajan, CCC-SLP is a Speech Language Pathologist with Language Fundamentals.  Ranjini is originally from India and is a graduate of the All India Institute of Speech and Hearing.  She is passionate about bi/multilingualism, cognition, language and adult speech and language disorders.