Difficulty swallowing, called dysphagia, can happen at any stage of Parkinson disease. Signs and symptoms can range from mild to severe and may include: difficulty swallowing certain foods or liquids, coughing or throat clearing during or after eating/drinking, and feeling as if food is getting stuck.
Usually, it is known that the prominent symptoms of dysphagia appear in the late stage of PD. A cohort study showed that severe dysphagia was reported approximately 10–11 years after the motor symptoms had appeared, and the prevalence was 68% even in the on-drug phase of patients with late-stage PD [9].
Parkinson's disease-related dysphagia may affect the oral and pharyngeal, as well as the esophageal phase of swallowing.
People with Parkinson's (PD) may notice changes in or difficulty chewing, eating, speaking or swallowing. These changes are more likely, and tend to worsen, as PD progresses and the muscles in the face, mouth and throat that are used in speaking and swallowing are affected.
Dysphagia likely happens in people with PD due to poor muscle movements. Muscles in the upper gastrointestinal (GI) tract may not move properly as a result of the affect PD has on muscles. For dysphagia to occur, the muscles in the esophagus may not contract as strongly, quickly, or in an organized way.
In Parkinson's, swallowing problems may cause coughing, choking or throat clearing when eating or drinking. Some people may feel like the food is getting "stuck" as it goes down. To evaluate swallowing problems, doctors may order a test that takes x-rays while you swallow foods and liquids of different consistencies.
The most prominent signs and symptoms of Parkinson's disease occur when nerve cells in the basal ganglia, an area of the brain that controls movement, become impaired and/or die. Normally, these nerve cells, or neurons, produce an important brain chemical known as dopamine.
Some people, especially later in Parkinson's, may have trouble chewing or swallowing, or difficulty with drooling. Others might have extra movements (dyskinesia) in the mouth or jaw, or they could grind their teeth. Parkinson's medications may cause dry mouth. Dry mouth increases the risk of cavities or gum disease.
Place a spoon or tongue depressor inside your mouth against your right cheek. Firmly press your tongue against the spoon/tongue depressor providing resistance with the spoon/tongue depressor. Repeat this exercise on the left side. Swallow very hard, squeezing the tongue and walls of the throat together with force.
Eating your meals shortly after taking levodopa (one of the main drugs for Parkinson's) may improve your swallowing, though the overall benefits of levodopa for swallowing are still unclear.
Parkinson's disease (PD) is a neurodegenerative disorder that affects the nerves and muscles. It can cause motor and non-motor symptoms. Excess phlegm is an example of a non-motor symptom of PD. Dysphagia is the main cause of phlegm in PD since it causes saliva and mucus to accumulate in the back of the throat.
This mental side of Parkinson's can start with confusion and progress to include hallucinations and dementia. The hallucinations, when coupled with dementia, is certainly one of the most heartbreaking aspects of Parkinson's. “The hallucinations and dementia, and returning to a 2nd childhood.”
More than 80 % of patients with Parkinson's disease (PD) develop dysphagia during the course of their disease.
You should see your doctor to determine the cause of your swallowing difficulties. Call a doctor right away if you're also having trouble breathing or think something might be stuck in your throat. If you have sudden muscle weakness or paralysis and can't swallow at all, call 911 or go to the emergency room.
In most cases, symptoms change slowly, with substantive progression taking place over the space of many months or years. Many people with PD have symptoms for at least a year or two before a diagnosis is actually made. The longer symptoms are present, the easier it is to predict how a person with PD will do over time.
Patients with stage four Parkinson's disease have visible bradykinesia and rigidity. In most cases, stage four patients need assistance to walk, stand, and move. When patients reach stage five – the final stage of Parkinson's disease – they will have severe posture issues in their back, neck, and hips.
Treatment is specific to the nature of the swallowing problem, but can involve strategies to help food or liquid go down safely (swallowing hard, holding breath while swallowing, tucking the chin while swallowing), diet changes (thickening liquids, making foods softer), exercises, or a combination of these.
Treatments for dysphagia
If your swallowing problems are being caused by a condition like acid reflux, the problem may get better on its own. But if the cause is longer term, you may need specialist treatment to make eating and drinking as safe as possible. This may include: medicines to treat acid reflux.
Put something flat like a spoon or tongue depressor on your tongue. Push against your tongue with the flat object, and push your tongue against the object. Hold for a couple of seconds. Repeat 5 times.
Why do people with Parkinson's experience speech and communication problems? Changes in the brain in people with Parkinson's mean that your movements become smaller and less forceful than before. This can lead to problems with your speech and communication.
Speech difficulties (dysarthria) and voice problems are very common in people with Parkinson's disease. Of the more than seven million people with Parkinson's disease worldwide, between 75% and 90% will develop voice and speech problems over the course of their illness.
People with Parkinson's may already struggle with dry mouth issues. Bacteria can grow in a dry mouth, leading to bad breath.
Available studies have shown that compared with healthy controls, patients with PD are accompanied by high rates of premature death. This is usually caused by factors such as pneumonia and cerebrovascular and cardiovascular diseases.
Parkinson's disease is a progressive disorder that is caused by degeneration of nerve cells in the part of the brain called the substantia nigra, which controls movement. These nerve cells die or become impaired, losing the ability to produce an important chemical called dopamine.
Some studies have reported that the average time from onset of Parkinson's to developing dementia is about 10 years. One large study found that about three-quarters of people who live with Parkinson's for more than 10 years will develop dementia.