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A sore throat is pain, scratchiness or irritation of the throat that often worsens when you swallow. The most common cause of a sore throat (pharyngitis) is a viral infection, such as a cold or the flu. A sore throat caused by a virus resolves on its own.

Strep throat (streptococcal infection), a less common type of sore throat caused by bacteria, requires treatment with antibiotics to prevent complications. Other less common causes of sore throat might require more complex treatment.

Also, someone who is HIV-positive might have a chronic or recurring sore throat due to a fungal infection called oral thrush or due to a viral infection called cytomegalovirus (CMV), which can be serious in people with compromised immune systems.

Rarely, an infected area of tissue (abscess) in the throat or swelling of the small cartilage "lid" that covers the windpipe (epiglottitis) can cause a sore throat. Both can block the airway, creating a medical emergency.

Each year, approximately one in 25 adults will experience a swallowing problem in the United States (Bhattacharyya, 2014). Dysphagia cuts across so many diseases and age groups that its true prevalence in adult populations is not fully known and is often underestimated.

Various neurological diseases are known to be associated with dysphagia. The exact epidemiological numbers by condition or disease also remain poorly defined. This, in part, is due to the concomitant medical conditions being reported and the timing and type of diagnostic procedures being used to identify swallowing disorders across neurological populations. Other studies have such findings as follows:

Not all signs and symptoms are seen in all types of dysphagia, and the evidence supporting the predictive value of these signs and symptoms is mixed. For example, coughing and throat clearing may not be correlated with penetration or aspiration of a bolus but may be the result of gastroesophageal reflux, esophageal dysmotility, and common medications (Elvevi et al., 2014; Madanick, 2013; Tafreshi & Weinacker, 1999). Signs and symptoms of dysphagia include

SLPs have knowledge of the anatomy, physiology, and functional aspects of the upper aerodigestive tract as they relate to swallowing and speech. SLPs also have expertise in communication disorders that may affect the diagnosis and management of swallowing disorders. SLPs work collaboratively with other professionals, individuals, families, and caregivers. Interprofessional practice (IPP) is critical to successfully achieving the desired improvements and outcomes due to complexities of assessment and treatment of swallowing disorders.

Comprehensive assessment includes non-instrumental and instrumental procedures. Instrumental procedures may not be indicated in select patients (e.g., a patient with ill-fitting dentures resulting in oral dysphagia or some patients with low levels of alertness who are unable to participate in the study). Instrumental procedures are the only method that provides visualization of swallowing physiology and laryngeal, pharyngeal, and upper esophageal anatomy, which help diagnose dysphagia.

The purpose of a non-instrumental swallowing assessment is to determine the presence (or absence) of signs and symptoms of dysphagia, with consideration for factors such as fatigue during a meal, posture, positioning, and environmental conditions. Verification of aspiration and thorough assessment of impairments in swallowing physiology or laryngeal/pharyngeal/upper esophageal anatomy require instrumental assessment.

The non-instrumental assessment of swallowing is insufficient to infer specific information about laryngeal, pharyngeal, or upper esophageal anatomy and physiology required to develop effective treatment options and prevent consequences of dysphagia, such as dehydration, malnutrition, pneumonia, and death (Garand et al., 2020).

SLPs use instrumental techniques to evaluate oral, pharyngeal, laryngeal, upper esophageal, and respiratory function as they apply to normal and abnormal swallowing. Instrumental procedures are also used to determine appropriateness and effectiveness of treatment strategies.

Instrumental assessment may include components of non-instrumental swallowing assessment (see above for further details). The purpose of the instrumental examination is to enable the SLP to perform the following tasks:

Other instrumental procedures are used primarily in research at this time but may develop into clinical diagnostic tools. Ultrasonography involves the use of a transducer to observe movement of structures used for swallowing, such as the tongue and hyoid (Hsiao et al., 2013; Sonies et al., 2003). High-resolution manometry is a technique used to measure pressures generated in the pharynx and esophagus. A thin catheter with pressure sensors < 1 cm apart is placed through the nose, pharynx, and esophagus. Various pressure measures can be calculated and compared to normative data (Omari & Schar, 2018).

SLPs should also be familiar with other diagnostic procedures performed by different medical specialists that yield information about swallowing function. These include procedures such as the esophagram/barium swallow, manofluorography, scintigraphy, 24-hr pH monitoring, and esophagoscopy.

Consideration of the underlying neurophysiological impairment is necessary for understanding swallow function and deficits. Different management approaches may be necessary for individuals with dysphagia that has resulted from an acute event, a chronic/stable condition, or a progressive neurological disorder. Treatment targeting a specific function or structure may also affect function in other structures.

Compensatory techniques alter the swallow when used but do not create lasting functional change. An example of a compensatory technique includes a head rotation, which is used during the swallow to direct the bolus toward one of the lateral channels of the pharyngeal cavity. Although this technique may increase swallow safety and/or efficiency during the swallow, there is no lasting benefit or improvement in physiology. The purpose of the technique is to compensate for deficits that cannot be or are not yet rehabilitated sufficiently.

Some techniques may be used for both compensatory and rehabilitative purposes. For example, the super-supraglottic swallow is a rehabilitative technique that increases closure at the entrance to the airway and may also serve as a compensation to protect the airway (McCabe et al., 2009).

Although the body of literature concerning the value of electrical stimulation for swallowing is large, the benefits remain unclear (Carnaby-Mann & Crary, 2007; Clark et al., 2009; Humbert et al., 2012; Sun et al., 2020). Electrical stimulation uses an electrical current in order to stimulate the peripheral nerve. SLPs with appropriate training and competence in performing electrical stimulation may provide the intervention. ASHA does not require any additional certifications.

Maneuvers are specific strategies that clinicians use to change the timing or strength of particular movements of swallowing. Some maneuvers require following multistep directions and may not be appropriate for patients with cognitive impairments. Examples of maneuvers include the following:

Swallowing exercises include exercises of the lips, jaw, tongue, soft palate, pharynx, larynx, and/or respiratory muscles to improve function. Some of these interventions can also incorporate sensory stimulation. Oral-motor treatments range from passive to active (e.g., range-of-motion activities, resistance exercises, or chewing and swallowing exercises). Examples of exercises include the following:

Prosthetics (e.g., palatal obturator, palatal lift prosthesis) can be used to normalize pressure and movement in the intraoral cavity by providing compensation or physical support for patients with structural deficits/damage to the oropharyngeal mechanism. With this support, swallowing efficiency and function may be improved. Intraoral appliances (e.g., palatal plates) are removable devices with small knobs that provide tactile stimulation inside the mouth to encourage lip closure and appropriate lip and tongue position for improved swallow function. This treatment option is most often used with patients following treatment for head and neck cancer; however, it may be implemented with other patients suffering from similar challenges.

Agency for Health Care Policy and Research. (1999). Diagnosis and treatment of swallowing disorders (dysphagia) in acute-care stroke patients (Evidence Report/Technology Assessment No. 8, AHCPR Publication No. 99-E024).

Barn Swallows have a steely blue back, wings, and tail, and rufous to tawny underparts. The blue crown and face contrast with the cinnamon-colored forehead and throat. White spots under the tail can be difficult to see except in flight. Males are more boldly colored than females.

Barn Swallows feed on the wing, snagging insects from just above the ground or water to heights of 100 feet or more. They fly with fluid wingbeats in bursts of straight flight, rarely gliding, and can execute quick, tight turns and dives. When aquatic insects hatch, Barn Swallows may join other swallow species in mixed foraging flocks.

A parasite is a creature that needs to live on or in another creature to survive. Often, the parasite causes problems for its host (the creature it depends on). Roundworms need the body of a human or other animal to mature into egg-laying adults.

Dysphagia is the medical term for difficulty swallowing. Dysphasia is usually a sign that there is a problem with your esophagus, the muscular tube that moves food and liquids from the back of your mouth to your stomach. 59ce067264

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