治疗-Dysphagia (swallowing problems)

大多数吞咽问题都可以管理，尽管您接受的治疗将取决于您患有吞咽困难的类型。

治疗will depend on whether your swallowing problem is in the mouth or throat (oropharyngeal dysphagia), or in the oesophagus (oesophageal dysphagia).

The cause of dysphagia is also considered when deciding on treatment or management. In some cases, treating the underlying cause, such as口腔癌或者oesophageal cancer，可以帮助缓解吞咽问题。

治疗for dysphagia may be managed by a group of specialists that may include a speech and language therapist (SLT), a dietitian and, possibly, a surgeon.

口咽吞咽困难的治疗

Oropharyngeal dysphagia can be difficult to treat if it's caused by a condition that affects the nervous system. This is because these problems can't usually be corrected using medication or surgery.

There are 3 main ways oropharyngeal dysphagia is managed to make eating and drinking as safe as possible:

• swallowing therapy
• dietary changes
• feeding tubes

Swallowing therapy

You may be referred to a speech and language therapist (SLT) for swallowing therapy. An SLT is trained to work with people with eating or swallowing difficulties.

SLTs use a range of techniques that can be tailored for your specific problem, such as teaching you swallowing exercises.

Dietary changes

You may be referred to a dietitian for advice about changes to your diet to make sure you receive a健康，平衡的饮食.

A SLT can give you advice about softer foods and thickened fluids that you may find easier to swallow. They may also try to ensure you're getting the support you need at meal times.

饲管

饲管can be used to provide nutrition while you're recovering your ability to swallow. They may also be required in severe cases of dysphagia that put you at risk ofmalnutrition和dehydration.

A feeding tube can also make it easier for you to take the medication you may need for other conditions.

There are 2 types of feeding tubes:

• a nasogastric tube– a tube passed through your nose and down into your stomach
• 经皮内窥镜胃造口术（PEG）管– a tube is implanted directly into your stomach

Nasogastric tubes are designed for short-term use. The tube will need to be replaced and swapped to the other nostril after about a month.

PEG tubes are designed for long-term use and last several months before they need replacing.

Most people with dysphagia prefer to use a PEG tube because it can be hidden under clothing. However, they carry a greater risk of minor complications, such as skin infection or blocked tube, compared to nasogastric tubes.

PEG管的两个主要并发症是感染和内部出血。

You can discuss the pros and cons of both types of feeding tubes with your treatment team.

治疗s for oesophageal dysphagia

Oesophageal dysphagia is swallowing difficulties due to problems with the oesophagus.

Medication

Depending on the cause, it may be possible to treat oesophageal dysphagia with medication. For example, proton pump inhibitors (PPIs) used to treat消化不良may improve symptoms caused by narrowing or scarring of the oesophagus.

Botox

Botox can sometimes be used to treatachalasia, a condition where the muscles in the oesophagus become too stiff to allow food and liquid to enter the stomach.

肉毒杆菌毒素可用于瘫痪收紧的肌肉，以防止食物到达胃。但是，效果仅持续大约6个月。

Surgery

Other cases of oesophageal dysphagia can usually be treated with surgery.

Endoscopic dilatation

Endoscopic dilatation is widely used to treat dysphagia caused by obstruction. It can also be used to stretch your oesophagus if it's scarred.

Endoscopic dilatation will be carried out during an internal examination of your oesophagus using anendoscopy.

An endoscope (a thin tube with a light and a camera at one end) is passed down your throat and into your oesophagus, and images of the inside of your body are transmitted to a television screen.

使用图像作为指导，通过食管的狭窄部分将其扩大。

If a balloon is used, it will gradually be inflated to widen your oesophagus before being deflated and removed.

You may be given a mild sedative before the procedure to relax you. There's a small risk that the procedure could cause a tear or perforation to your oesophagus.

插入一个支架

If you haveoesophageal cancerthat can't be removed, it's usually recommended that you have a stent inserted instead of endoscopic dilatation. This is because, if you have cancer, there's a higher risk of perforating your oesophagus if it's stretched.

A stent (usually a metal mesh tube) is inserted into your oesophagus during an endoscopy or underX射线指导。

The stent then gradually expands to create a passage wide enough to allow food to pass through. To keep the stent open without blockages, you'll need to follow a particular diet.

治疗s for babies born with dysphagia

如果您的婴儿天生难以吞咽（先天性吞咽困难），他们的治疗将取决于原因。

Cerebral palsy- 言语和语言治疗师（SLT）将教您的孩子如何吞咽，如何调整他们吃的食物类型以及如何使用喂食管。

Cleft lip and palate– this is usually treated with surgery.

食管变窄– may be treated with a type of surgery called dilatation to widen the oesophagus.