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[DYSPHAGIA] xerostomia
I have had personal experience with xerostomia because of a medication that I took for a short period of time. It was short because I was having so many problems: dry mouth, sticky mouth, trouble swallowing, especially dry or sticky foods, very hoarse voice. I had trouble swallowing pills as well. I had no oral weakness, no increased coughing, no asymmetry. I completely understand the problems she is having. Sucking on hard candy and taking sips of fluid did not really help me. It took about two weeks of taking the medication before my symptoms began to affect my swallow and voice and it took at least another two weeks after I stopped the med before things began to return to normal.
Marie Isbell
>>> "rayhagan" <rayhagan@msn.com> 11/25/01 11:02PM >>>
I just completed an MBS on a 50 + y/o patient who has experienced several "TIAs", the most recent in June. She has experienced a change in voice and complains of difficulty swallowing with pills sticking and similar symptoms with food at times. On occasion she begins to cough without anything in her mouth at all. I was unable to stimulate a gag reflex and her mouth seemed extraordinarily dry - another complaint that she voices which she attributes to an antidepressant she takes. There was no oral weakness or assymetry. The MBS demonstrated flash penetration with initial trials of thin fluid which cleared spontaneously. Later in the eval penetration did not occur. What was remarkable was how food stuck in the pharyngeal area above, in and below the vallecula. With repeated swallows she was able to eventually clear these boluses, but had most difficulty with dry food. I'm wondering if anyone has any experience with xerostomia and if it could be so severe that it would produce this kind of dysphagia. It looks as though her tongue base makes contact with the pharyngeal wall. If that didn't occur I would be more likely to think it was decreased tongue base strength.. I'm wondering if anyone has any experience with xerostomia and if it could be so severe that it would produce this kind of dysphagia? What about voice changes? Or should I be looking more closely at neurologic causes? Thanks lh
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