Name of the Condition

• Dysphagia, Oral Phase
• Common names include oral phase dysphagia or swallowing difficulty related to the mouth.

Summary

Dysphagia, oral phase, is a medical condition characterized by difficulty in starting the process of swallowing. This involves challenges in forming or moving a bolus (a small rounded mass of a substance to be swallowed) within the mouth to initiate swallowing.

Causes

This condition is often caused by:

• Neurological disorders such as Parkinson's disease, stroke, or cerebral palsy.
• Structural anomalies like cleft palate or tumors.
• Muscular issues including muscular dystrophy or myasthenia gravis.

Risk Factors

Factors that may increase the likelihood of developing oral phase dysphagia include:

• Advanced age, due to diminished muscular function and coordination.
• History of neurological diseases.
• Involvement in head, neck, or dental surgeries impacting muscle or nerve function.

Symptoms

Typical signs of oral phase dysphagia include:

• Difficulty holding food or liquid in the mouth.
• Trouble initiating swallowing.
• Coughing or choking while eating.
• Recurrent respiratory infections due to aspiration.

Diagnosis

Diagnosis can involve:

• Clinical assessment by a speech-language pathologist.
• Videofluoroscopic swallow study (VFSS).
• Fiberoptic endoscopic evaluation of swallowing (FEES).
• Evaluation of oral muscle strength and coordination.

Treatment Options

Treatment varies based on the underlying cause but generally includes:

• Swallow therapy with a speech-language pathologist.
• Dietary modifications to alter food textures and consistency.
• Medications to manage underlying neurological conditions.
• Surgical interventions in rare cases where structural problems exist.

Prognosis and Follow-Up

The prognosis depends on the underlying cause. With therapy and treatment, many individuals see improvements. Regular follow-ups with healthcare providers and therapists are crucial to monitor progression and adjust treatment plans.

Complications

If left untreated, dysphagia can lead to:

• Malnutrition or dehydration.
• Aspiration pneumonia from food or liquid entering the lungs.
• Decreased quality of life due to eating difficulties.

Lifestyle & Prevention

Adapting eating habits, like sitting upright while eating, can manage symptoms. Preventive measures are limited and largely involve managing risk factors like treating neurological disorders promptly.

When to Seek Professional Help

Seek professional help if experiencing consistent difficulty swallowing, frequent coughing or choking while eating, or unexplained weight loss.

Additional Resources

• Dysphagia Research Society (dysphagiaresearch.org)
• American Speech-Language-Hearing Association (asha.org)

Tips for Medical Coders

• Ensure accurate coding by confirming the swallowing phase affected is the oral phase.
• Common errors include confusing oral phase dysphagia with pharyngeal or esophageal phases; verify symptoms and assessments to avoid miscoding.