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What Causes Swallowing Problems?

UVA Otolaryngologist James Daniero, MD discusses what causes swallowing problems. Partial Transcript: MELANIE COLE: At University of Virginia Health System, we are for bringing advanced care closer to home. So we're bringing health knowledge directly to you with UVA Health System Radio. Here's Melanie Cole. Swallowing is complex. And a number of conditions can interfere with this process. What are the most common causes of swallowing problems? And what treatments are available to help? My guest today is Dr. James Daniero. He's a board certified otolaryngologist head and neck surgeon who specializes in caring for patients with voice and swallowing conditions. Welcome to the show, Dr. Daniero. What are the most common causes of swallowing problems? JAMES DANIERO: Yes, well first of all, thank you, Melanie, for having me on the show. The most common cause of swallowing problems typically happen to the elderly population. And that involves stroke neurodegenerative diseases, such as Parkinson's disease, dementia, and ALS, or Lou Gehrig's disease. It can be also a consequence of radiation for treatment of other disorders, primarily head and neck cancer, as well as neck surgery or neck trauma. MELANIE COLE: How is this diagnosed? What do you do to diagnose a swallowing problem? JAMES DANIERO: Sure. I think the primary thing, the best thing I have to look at swallowing problems is talking with the patient. It's just getting a good what we call a history, the onset and the type of symptoms. When I talk with patients, I ask them what kind of foods are they having trouble with. And what particular situation do they describe that they're having trouble swallowing in. And that really narrows me in. Primarily, there's two different types of swallowing disorders. One is swallowing disorders related to liquids. And that's a whole different set of problems than those are related to solid foods, such as meats or breads that people will complain of difficulty with. MELANIE COLE: What is that surgery like? People would hear about swallow surgery and get very nervous, get scared. It sounds very scary. Because this is your ability to eat, and to talk, and so it's really a sensitive area. Tell us a little bit about the surgery. JAMES DANIERO: Sure. So the newer approaches, and what I am actually a specialist in, is the endoscopic approaches. This is, within the past 20 years, we've really revolutionized the way we treat swallowing disorders and now have incisionless was surgery, a minimally invasive approach. And for patients, it typically involves coming in to the hospital, spending a night over in the hospital, but going home the next morning and then generally, with almost immediate relief. The relatively limited pain, most patients complain they have a sore throat, like they had a strep throat or something. And then they are back on to swallowing with usually, impressive results. MELANIE COLE: That's amazing. And in just the last minute or so Dr. Daniero, why should patients come to UVA for treatment of their swallowing problems? JAMES DANIERO: One thing for patients to look for when they're evaluating a place for a possible treatment of their swallowing problem is to look for someone who is a fellowship trained laryngologist. And that's some of the training that I received. That is an otolaryngologist, or an ear, nose, and throat doctor, that specializes in voice and swallowing and has special training regarding that. There's only a handful of providers in the state of Virginia that provide this service and have this designation, of which UVA is one of them. We also have a team approach to swallowing disorders. And I have a voice and swallowing specialized clinic, which I work with a speech and language pathologist. And we can perform some of the swallowing evaluation right in clinic on the same day. We can even perform in-office surgeries for swallowing disorders, where the patient doesn't have to be admitted to the hospital. And they can come in and out. They can even drive themselves to their own appointment to have these procedures. Because there's no sedation or anesthesia, other than just numbing the throat.