Dysphagia, or difficulty swallowing, is a disorder that can be a symptom of many neurological health conditions, including multiple sclerosis (MS).
Dysphagia is a common problem in people with advanced MS due to problems with muscle and nerve control. Difficulty swallowing can occur when there is a loss of control in any of the muscles involved, such as the mouth, tongue, throat, pharynx, or esophagus.
This can lead to suffocation, difficulty eating, pain, poor nutrition, and other health problems. This disorder can be improved with the care of your doctor and healthcare team.
Read on for information on this common condition in MS, what causes it and what can help those who may be suffering from it.
MS is a chronic inflammatory disease of the central nervous system that makes it difficult for messages to flow between the brain and the body. There are many common symptoms of MS, such as fatigue, weakness, and changes in speech.
Another symptom of MS is difficulty swallowing, which is a complex process with more than 50 muscles and nerves involved. Also known as dysphagia, this disorder can be caused by any condition that makes it difficult for the muscles and nerves needed to swallow, such as MS, Parkinson’s disease, or stroke.
It is very common in people with MS. Up to a third of people are diagnosed with these swallowing-related symptoms. This can include weak muscles in the tongue or cheeks that make it difficult to move food in the mouth to chew.
Swallowing problems are more common in later stages of MS, but can happen at any time. Like many common symptoms of MS, dysphagia can improve over time, but also get worse during an outbreak.
Difficulty drinking fluids, including suffocation or coughing, is one of the first signs of dysphagia.
Other symptoms of dysphagia can range from mild to severe. In addition to difficulty swallowing, people with MS dysphagia may have:
- dry mouth
- weaker tongue muscles
- loss of any movement of the tongue
- slower and less coordinated chewing
- a delay in the activation of the sip reflex
- numbness of the mouth and throat
- clear throat frequently
- feeling that the food is stuck in their throats
- feeling coughing or choking when eating or drinking
- drooling and inability to control drooling
For people with MS who have trouble swallowing, it may be related to problems with brain nerves (cranial nerve paresis), brainstem problems, or other cognitive dysfunctions.
In addition, people with MS may experience nerve damage that causes numbness in their mouth and throat. MS can weaken the voluntary and involuntary muscles that help swallow.
There are certain risk factors that make dysphagia more common in general if you have MS:
- Nervous problems. People with MS who have nerve problems in the brain that cause motor problems are more likely to have dysphagia.
- Aging. If you have MS for a long time, you are more likely to have dysphagia. Older people may also be more likely to have dysphagia, according to this oldest 2009 study.
- Medications. Some medications prescribed to control the symptoms of MS can also cause dry mouth, making the symptoms of dysphagia worse.
- Eating and drinking problems. People with MS may face challenges in eating and drinking fluids. Eating dry or crunchy foods and not drinking enough water and other fluids to stay hydrated can make the symptoms of dysphagia worse.
Dysphagia can be more severe if you have MS because you have a higher risk of suffocation and aspiration, as fluids or food can enter your airways or lungs.
This is a major danger because it can cause other health problems, such as pneumonia. Dysphagia can cause other complications, such as malnutrition and dehydration.
There are several methods that doctors use to help identify dysphagia and treat this disorder in people with MS:
- A doctor may ask you to eat or drink something to observe your symptoms.
- You may need to fill out a specific questionnaire form and take clinical examination tests, such as a barium swallow. This imaging procedure is used to look at the muscles and nerves used to eat and drink.
- With the help of a scan, a doctor can identify which muscles are hampering your ability to chew or swallow.
- If you have dysphagia, your doctor may also recommend that you contact a speech therapist. A speech therapist may recommend exercises to help you improve your swallowing if you have dysphagia.
- Changes in your diet and how you prepare food can help you eat or drink. These include adding thickeners to foods to make them easier to swallow.
- Doctors may use medications, such as botulinum injections, to help treat some people who have trouble swallowing food. In severe cases, a feeding tube or surgery may be needed to help with the symptoms and complications of dysphagia.
If you have MS, tell your doctor immediately if you have difficulty swallowing, drinking or chewing. Early treatment and management are important to help prevent complications.
Your healthcare team can help you determine the best treatment, therapy, exercise, and dietary changes to better manage your dysphagia.
Dysphagia, or difficulty swallowing, can occur in some people with MS and other conditions that affect the nerves and muscles. It can sometimes be a serious problem and cause complications.
If you have dysphagia, there are treatment options and resources to help you deal with this condition.