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[Dysphagia] Hiatal hernia



It sounds like reflux/GERD would be a direct contributing factor to his 
esophagitis esp. given his hiatus hernia - the acid can burn the 
esophagus, pharynx, etc. I see a lot of patients with GERD who have 
esophageal problems, and sometimes pharyngeal problems too. I once saw 
regurgitation/backflow on an MBS right into the oral cavity. They 
describe sensations of food sticking, not going down fast enough, 
making them gag, etc.  I would go straight to the MD for GERD Dx and 
Rx. When they are managed properly for their GERD, their swallowing can 
be quite functional. This gentleman may have to make some lifestyle 
changes plus meds. I am not aware though, of an SLP regimen to reduce 
regurgitation.

Perhaps others have different ideas?

Sharon

On Apr 27, 2005, at 2:38 PM, AnnaMaria Koo wrote:

> Not sure it this is within our scope of practice but I received a
> referral for a 78 yr gentleman who has bouts of nausea/vomiting for
> several months. On endoscopic examination they found  hiatus hernia and
> esophagitis.  Amongst other medical issues he was placed on a minced
> diet and thin fluids due to mild oropharyngeal dysphagia.  He also
> consistently has sensation of regurgitation (although he may not 
> produce
> actual food/liquid) My question is that is there any direct 
> intervention
> from an S-LP perspective that would reduce regurgitation?  Dietitians
> would have recommendations in terms of diet modifications.  However I
> don't see a correlation with this patient's dysphagia and hiatus hernia
> /esophagitis....but I could be wrong.
>
> Anna Maria
>
> Anna Maria Koo
> Speech-Language Pathologist
> Specialized Geriatric Services & CORP
> SJHC, Parkwood Site
> ext.42205
>
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