Esophageal Dysphagia: Role of the Speech Pathologist
Presented by Barbara Pisano Messing
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This course gives students an overview of esophageal disorders and the implications for speech pathologists in the diagnosis and management of esophageal dysphagia. A brief review of specific esophageal abnormalities commonly impacting dysphagia is presented. Participants will learn to identify the significance of the interrelationships between oral, pharyngeal, and esophageal disorders on dysphagia diagnosis and management. Instrumental evaluation tools and protocols will be addressed. This course is appropriate for speech pathologists responsible for the management of patients with swallowing disorders in any setting, but particularly targets those in acute medical and rehabilitation settings.
Meet your instructor
Barbara Pisano Messing
Barbara Pisano Messing is a practicing speech pathologist with 36 years of clinical and administrative experience. Dr. Messing was the administrative-clinical director of the Milton J. Dance, Jr. Head and Neck Center, Head and Neck Surgery, and Johns Hopkins Voice Center at GBMC in Baltimore, Maryland, for 22 years. She is…
Chapters & learning objectives
1. Predictors and Indicators of Esophageal Dysphagia: Differential Diagnosis
The interrelationships between the oral, pharyngeal, and esophageal disorders must be considered during the evaluation process. Differential diagnoses of oropharyngeal and esophageal dysphagia rely on thorough patient history, patient complaints, signs and symptoms, and findings from the instrumental evaluation. However, the patient’s clinical complaints and reports regarding the site of dysphagia may be unreliable and do not necessarily correlate with the actual problem. This chapter covers predictors and indications for esophageal dysphagia.
2. Esophageal Anatomy
This chapter discusses the normal anatomy and physiology of the esophagus. It is important for the speech pathologist to understand normal esophageal structure and function in order to identify, along with the radiologist, any abnormalities.
3. Esophageal Motility Disorders
Esophageal structural and motility disorders contribute to esophageal dysphagia and dysfunction. It is important to classify disorders based upon structural or functional findings. Speech pathologists need to be able to identify esophageal disorders that contribute to esophageal dysphagia. Diagnostic procedures are critical in detecting anatomic and motility disorders (videofluoroscopy, manometry, endoscopy, imaging). This chapter briefly reviews structural and esophageal motility disorders and appropriate diagnostic options.
4. Esophageal Structural Disorders
Esophageal dysphagia involves appropriate diagnosis and medical management. The medical management of esophageal dysphagia may involve a multidisciplinary team (gastroenterologist, radiologist, head and neck surgeon, and the speech pathologist). This session will review esophageal structural and functional abnormalities, along with radiographic findings.
5. Esophageal Disorders: Inflammatory
There are numerous etiologies that contribute to esophageal dysphagia. Appropriate medical management of esophageal dysphagia may involve a multidisciplinary team (gastroenterologist, radiologist, head and neck surgeon, and the speech pathologist). This session will review esophageal disorders related to an inflammatory process or cause, along with radiographic images.
6. Esophageal Disorders, Secondary Motility Disorders, and Functional Disorders
Multifactorial causes contribute to esophageal dysphagia, which impacts esophageal motility. Functional esophageal disorders consist of a disease category that presents with esophageal symptoms. Although swallow therapy is not indicated in these cases, the speech pathologist can provide diet and lifestyle recommendations that may improve the patient’s symptoms. This session will review esophageal disorders related to symptoms caused by other disorders, such as gastroesophageal reflux disease.
