Aspiration and Dysphagia in Parkinson's Disease

This article of "Nutrition 101" focuses on dysphagia (difficulty swallowing) in individuals with Parkinson's Disease (PD). It highlights the risk of aspiration, where food or liquid enters the lungs instead of the stomach. The article aims to explore the symptom, its causes, implications, and management strategies.

Written By: Renee Rouleau- B.S., PhD student, Jacobs School of Biomedical Sciences, University at Buffalo

Fact about Aspiration and Dysphagia:

• It takes over 50 muscles to coordinate chewing and swallowing. (Ertekin, & Aydogdu, 2003)
• In PD, these muscles move slower and less precisely, making it harder to chew, move food to the back of the mouth, and swallow safely.
• This can lead to coughing, choking, and food getting stuck in the throat.
• The longer food lingers, the greater the risk of aspiration (food or liquid entering the airway/lungs instead of the stomach).
• Untreated dysphagia can lead to malnutrition, dehydration, and lung infections.
• Dysphagia symptoms may start mild but worsen over time, affecting up to 80% of PD patients.(Kalf et al., 2012)

Key points about aspiration in PD:

• Normally, the epiglottis prevents food from entering the airway.
• In PD, slower reflexes can impair the epiglottis' function.
• This can lead to "silent aspiration," where food enters the lungs without a cough
• reflex.
• Aspiration pneumonia can result, requiring emergency care.
• Early symptoms of aspiration pneumonia can mimic a cold or flu.
• Worsening symptoms include chest pain, shortness of breath, and high fever.

To recognize and address aspiration:

• Be aware of the risks and symptoms.
• Seek medical attention if you suspect aspiration.
• Early intervention is crucial to prevent serious complications.

Dysphagia symptoms can develop slowly, often leading to them being overlooked until a serious complication, such as pneumonia, occurs.

Common signs to watch for:

• Taking longer to chew or swallow food.
• Coughing or choking while eating or drinking.
• Feeling like food is stuck in the throat.
• Drooling or difficulty managing saliva.
• A weak, hoarse, or gurgly voice after swallowing.
• Unexplained weight loss
  

Diagnostic tests:
SLPs can perform tests such as:

• Modified barium swallow study (MBSS).
• Fiber optic endoscopic evaluation of swallowing (FEES).
• These tests help assess how food and liquid move through the throat, identify the source of the problem, determine symptom severity, and guide treatment.(Sutterup & Warnecke, 2015).
  

Note: It is critical that early detection and intervention for dysphagia in individuals with PD takes place to prevent serious complications. Those living with Parkinson’s and care partners must ensure to provide detailed information about symptoms and to ask questions about their health.

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Yours, Coach B

Rock Steady Boxing Certified Coach
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