Dysphagia, or difficulty swallowing, effects many patients with Duchenne. Complaints of "something stuck in my throat" are not uncommon. Symptoms may progress to difficulty swallowing saliva, coughing during and after meals, increased meal duration, difficulty starting swallowing, loss of appetite, unintentional weight loss, and increased occurrence of chest infections and choking episodes. Until now, there has been little guidance available for clinicians to manage dysphagia and improve feeding for people with Duchenne.
Dysphagia in Duchenne and other neuromuscular diseases is different from the more common "central" forms of dysphagia. Central forms of dysphagia are related to poorly coordinated swallowing. This can cause aspiration (fluids entering the lungs, rather than the stomach) during drinking. The neuromuscular form of dysphagia present in Duchenne is a result of progressive muscle weakness and accompanies solid rather than liquid intake. Neuromuscular dysphagia requires different management than central dysphagia. It is therefore important that the type of dysphagia be diagnosed and managed correctly.
A new article, Dysphagia in Duchenne muscular dystrophy: practical recommendations to guide management (PDF), presents a clear algorithm (step by step plan of care) to diagnose and manage dysphagia in patients with Duchenne. PPMD believes this algorithm will be an invaluable tool in our care arsenal.
Click below to download this new resource article that presents an algorithm (plan of care) for correctly diagnosing and managing dysphagia in Duchenne: