Special Consideration: Congestion + GERD + Fatigue
Dysphagia is caused by something, a diagnosis or multiple diagnoses in fact. The symptoms that the dysphagia causes are indicative of the level of risk that you have for adverse health events related to the dysphagia. Being congested, whether temporarily or on a chronic basis, is cause for concern. This may be caused by the food or liquid, or both, falling into the airway before, during, or after the swallow. This can be happening because of reflux or it can happen because you cannot control the texture of the food or liquid and may not feel it as its falling into the airway.
Bottom line, being congested is a risk for complications on its own. If you add the coughing during meals that often accompanies congestion to that scenario, you must determine whether the cough is being caused by the food or liquid falling into the airway or because you are stirring up the congestive secretions and phlegm during the swallowing process. Only a thorough swallowing diagnostic can determine the effect that the congestion is having during the meals.
GERD, or reflux, is more complicated as it is caused by a malfunction in the gastrointestinal systems and is a normally a combination of the function of the anatomy of your GI system along with diet and lifestyle choices. When the reflux re-enters the pharynx, or throat, it then is either swallowed again or it can fall into the airway in aspiration. This can even be happening when you sleep. Since 50% of all reflux is silent, meaning that you don't know its happening because you aren't feeling heartburn symptoms, you might not even be aware of this increased risk from effects of reflux.
Fatigue is something that is often overlooked as a risk for dysphagia. The amount of energy that it takes to chew, move the food and liquid through the mouth and throat, hold one's breath for 1-2 seconds to complete the swallow, and repeat this over and over hundreds of times, is understated. It takes a lot of energy to eat, and depending on the texture of the food, that energy can be increased or decreased. Often patients start out with strong swallows and because of the fatigue they are experiencing from their diagnostic profile, their swallow weakens after a short time and the risk of aspiration increases.
Having chosen these three symptoms in your quiz, the combination increases your risk of complications of dysphagia such as coughing, choking, aspiration, congestion, pneumonia, dehydration and even malnutrition. It can affect how you feel in a negative way and can delay or detour your rehabilitation or management of your medical diagnoses. The more symptoms one is experiencing, the more deleterious the effects of dysphagia might be.
A conversation with your SLP Dysphagia Expert to discuss your symptoms may be in order to re-direct you towards figuring out what you can do to reduce or eliminate these symptoms and potentially have a more positive rehabilitation experience.