Dysphagia Causes and Treatments for the Elderly 

Dysphagia or difficulty swallowing affects about 10 to 33% of older adults. If left untreated, it can cause the inability to eat or drink and lead to malnutrition.

Losing this seemingly simple skill can also lead to depression among elderly folk. Fortunately, dysphagia is a condition that can be addressed. Read on to learn about the causes of dysphagia and how to treat this geriatric condition.

What Causes Dysphagia? 

Dysphagia is characterised by compromised neuromuscular organ function from when food enters the mouth and travels through the oesophagus. There are three types:  

• Oral cavity dysphagia: Decreased ability to form a mass of chewed food (also called a bolus). 
• Pharyngeal dysphagia: Faulty swallowing reflex mechanism in the tongue and upper oesophageal sphincter muscle. The bolus becomes stuck, moves too slowly, or accidentally enters the trachea.  
• Oesophageal dysphagia: Strictures or other structural abnormalities in the oesophageal tract compromise the movement of the bolus down to the stomach.  

Several conditions can also cause dysphagia. Stroke survivors, as well as people with dementia and Parkinson’s disease, are more prone to choking due to delayed muscle reflexes.

Other conditions such as throat infections, disorders of the oesophagus (GERD, swollen thyroid glands, oesophageal cancer), and certain medications may make it painful or difficult to swallow properly. 

Dysphagia in TCM 

Dysphagia is also recognised in Traditional Chinese Medicine (TCM) as a symptom of the disruption in the flow of qi (vital life force). This disruption is caused by the formation of phlegm, which itself could be a syndrome of a few types of Deficiencies:  

• A deficient Spleen results in sluggishness along the meridians involved in swallowing. 
• A deficient Liver and Kidney essence leads to neurological problems. 
• An imbalance in the yin and yang, primarily through Yin Deficiency, results in phlegm and Qi Stagnation. 

Addressing Dysphagia in Ageing Adults 

Treatments for dysphagia include:  

1. Relearning how to swallow  

The goal of swallow therapy is to work with a patient’s limitations in neuromuscular functions without altering the physiology of swallowing itself. Changing the position of their head and body posture while eating are two ways to help them swallow.

They should raise their head by 45-60 degrees when they eat and avoid lying down immediately within one to two hours after food to prevent gastroesophageal reflux and coughing.

2. Change the texture of foods 

In addition to learning swallowing techniques, changing the texture of food is another strategy to make swallowing easier. Thicken liquid foods before feeding to prevent choking. Cut up and soften hard foods by boiling or blending. 

3. Smaller and more frequent meals 

Those with dysphagia may not be able to sit through a complete meal. Opt for smaller and more frequent meals to ensure adequate nutrition. 

4. Maintain oral hygiene and treat infections 

Unchecked dysphagia in older adults can lead to infections when pieces of undigested food remain in the oral cavity or enter the lungs. Be sure to keep the mouth clean during and after eating. If they’re suffering from an infection, talk to a doctor about the right antibiotics or antivirals. 

5. TCM: Acupuncture and herbal therapy 

Acupuncture treats dysphagia by improving blood circulation in the base of the skull and increasing oxygen supply to brain tissues. This, in turn, improves neurological and muscular function in the swallowing mechanism. A study of 64 stroke patients treated with acupuncture for 28 days shows a 92.2% efficacy rate. 

A recent study also shows that combining acupuncture and herbs significantly improved dysphagia symptoms in an elderly female patient after four months of treatment. The 68-year-old suffered from progressive bulbar palsy, a neurological condition characterised by impaired swallowing and salivation. Herbal therapy used huang qi (黄芪), also known as astragalus or milkvetch root, which nourishes blood and tonifies qi. 

Dysphagia is a condition that some of us will have to contend with as we age. However, this doesn’t mean elderly folk should have to suffer through this condition. Having a good understanding of dysphagia causes helps us treat it and maintain a good quality of life.

Do you have other tips for helping an elderly relative with dysphagia? Share them below! 

This is an adaptation of the article “家中老年人吞咽障碍, 该怎么做？” which first appeared on the Health123 website.