Treating Swallowing Disorders

Speech-Language Pathologists treat patients with a variety of speech-language and swallowing disorders. The American Board of Swallowing and Swallowing Disorders describes this individual as an individual with” high-level skills and clinical experience in the evaluation and treatment of swallowing disorders”.

A swallowing disorder, called dysphagia, is a difficulty or inability to swallow. There are different phases of the swallow. The problem can affect any phase of the swallow. What happens in the mouth is the oral phase. What happens in the throat is the pharyngeal phase. What happens in the esophagus, is called the esophageal phase. A person can have difficulty in any or all of the phases of the swallow. If the person can’t eat or drink enough, this will affect their nutrition.

What causes Dysphagia?

Normally, the muscles in your throat and esophagus squeeze, or contract, to move food and liquids from your mouth to your stomach without problems. Sometimes, though, food and liquids have trouble getting to your stomach. The muscles and nerves that help move food through the throat and esophagus are not working right. This can happen if you have:

  • Had a stroke or a brain or spinal cord injury.
  • Problems with your nervous system, such as multiple sclerosis, muscular dystrophy, or Parkinson’s disease.
  • An immune system problem that causes swelling and weakness.

A dry mouth can make dysphagia worse. This is because you may not have enough saliva to help move food out of your mouth and through your esophagus. A dry mouth can be caused by medicines or another health problem.

What is a Board Certified Swallowing Specialist (BCS-S)?

Speech-Language Pathologists treat patients with a variety of speech-language and swallowing disorders. The American Board of Swallowing and Swallowing Disorders describes this individual as an individual with” high-level skills and clinical experience in the evaluation and treatment of swallowing disorders”. A BCS-S speech-language pathologist has chosen to specialize in this area, that is, they devote a significant amount of their clinical practice and continuing education to diagnosing and treating this complex disorder. Because of this dedication and training, the latest, state-of-the art clinical approaches and can most effectively and efficiently evaluate and treat individuals with swallowing disorders.

How Can a Speech Pathologist/Swallowing Specialist Help?

A SLP can diagnose and treat swallowing disorders through instrumental examinations. The Modified Barium Swallow Study is a common older procedure for the assessment of dysphagia. Fiberoptic Endoscopic Examination of Swallowing (FEES) is a well-established imaging technique that has revolutionized the field of dysphagia diagnostics.

What is FEES?

Fiberoptic Endoscopic Evaluation of Swallowing (FEES) is an assessment tool used to evaluate swallowing function and guide the treatment of swallowing disorders (dysphagia). A small flexible camera called an endoscope will be placed in one of your nostrils and moved through your nose just above the throat. This allows the SLP to observe food and liquid as it passes through your throat. You will be given different consistencies to eat and drink that have been dyed with food coloring. The food coloring is used to help the food and liquid show up easily when you swallow it. The pictures from the test will be recorded so that you may review the results with the SLP immediately.

The use of endoscopy by SLPs is for the assessment and management of oro-pharyngeal dysphagia, but NOT for medical diagnoses. As with other instrumental dysphagia assessments, the aim of FEES is to determine the cause of the dysphagia and the factors and/or strategies that may improve or manage the dysphagia. FEES can provide valuable information regarding:

  • How you manage your saliva
  • Sensation in your throat which is important for swallowing
  • Protection of food going into the lungs
  • If food you eat is leaving excess residue which can be a potential problem for some people

The passing of scope may cause some initial discomfort, but once the endoscope is positioned above the throat, the discomfort is minimal. The procedure is extremely safe with a low-risk of complications or side-effects. FEES can be done in the office in less than 30 minutes and a full report is sent to your referring physician.

To schedule an appointment with Yvette M. McCoy, MS CCC-SLP, BCS-S
Board Certified Specialist in Swallowing and Swallowing Disorders visit speakwellsolutions.com

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Yvette M. McCoy, MS CCC-SLP, BCS-S
Yvette McCoy is a speech-language pathologist with over 23 years experience, specializing in adult neurological rehabilitation with a special interest in dysphagia and stroke rehabilitation. She owns Speak Well Solutions, LLC, a thriving practice, which currently employs five staff speech-language pathologists. Speak Well Solutions, LLC has been serving both adult and pediatric populations in St. Mary’s County since 2005. She is certified by the American Speech-Language-Hearing Association (ASHA), a board certified swallowing specialist (BCS-S) by the American Board of Swallowing and Swallowing Disorders and six time ACE awardee (Award for Continuing Education) She currently serves on the Adult Services Committee for the Maryland Speech-Language and Hearing Association. She is a member of the Dysphagia Research Society and serves on their Website Communications and Public Relations Committee. She is also a member of ASHA’s Dysphagia Special Interest Group Editorial Review Committee. She co-created/authored the mobile app 'Dysphagia Therapy', that Is available in the iTunes store. She is also a published author for the ASHA National Magazine, The Leader. Other voluntary activities include peer reviewer for continuing education courses, guest lecturer and invited speaker at regional and national conferences on topics related to adult swallowing disorders. Finally, she is an adjunct instructor at the University of Maryland, College Park.