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Problems Swallowing as a Symptom of Multiple Sclerosis

Posted Jan 27 2010 12:00am

BEING this is one of my Symptoms, I had to provide it to you after receiving it from: about.com_MS

It's a good thing my wife knows the Hiemlich maneuver. She has unfortunately needed to use it on me a couple of scary times... Yes,, a very scary ordeal..

Dysphagia Can Be Subtle, But Dangerous
It seems like swallowing would just be second nature, not something we have to think about in order to do safely. However, swallowing is a complicated process that involves all sorts of muscle coordination and feedback to and from the brain through certain nerves and neural pathways. Multiple sclerosis (MS) can damage any of these nerves as well as the area of the brain responsible for coordinating swallowing, the brainstem. This can lead to swallowing difficulties, called dysphagia.

What do MS-Related Swallowing Problems Feel Like ?

Dysphagia includes many different problems with the swallowing process, even those that don't seem directly related to swallowing food, including:
  • Difficulty chewing
  • Coughing while eating or immediately afterwards
  • Excessive saliva or drooling
  • Choking
  • Food sticking in the throat
  • A weak, soft voice
  • Feeling that it is hard to swallow food or move it to the back of the mouth
  • Aspiration, meaning food or drink is going down the windpipe into the lungs
  • Vomiting food back up
    How Common Are MS Related Swallowing Problems?
    Between 30 and 40 percent of people with MS experience swallowing problems at some time. However, for many people with MS-related dysphagia, these changes are so subtle that they may not be aware of them, besides experiencing the occasional coughing fit after something “goes down the wrong way.”

  • What Causes MS Related Swallowing Problems?
  • Several different factors can contribute to swallowing problems, but the main cause of dysphagia are
    lesions in the part of the brain that controls swallowing (primarily the brainstem) or the nerves that provide feedback to the brain.

    Dysphagia can also be caused or made worse by lack of saliva or dry mouth. Some medications used to control MS symptoms can cause a dry mouth, including:

  • Anticholinergics, prescribed for bladder dysfunction or diarrhea, including: propantheline, (Norpanth, Pro-Banthine) and dicyclomine (Bentyl)
  • Tricyclic antidepressants, such as amitriptyline (Elavil, Endep), desipramine (Norpramin),doxepin (Sinequan), (Tofranil-PM), nortriptyline (Pamelor).
  • Selective Serotonin Reuptake Inhibitors (SSRIs), including fluoxetine (Prozac), sertraline (Zoloft), citalopram (Celexa) and paroxetine (Paxil).
  • Norepinephrine Reuptake Inhibitors, a newer class of antidepressants, which includes venlafaxine (Effexor) and duloxetine hydrochloride (Cymbalta).
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