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[Dysphagia] Thick mucus



Rene - thanks for this complete & useful comment.

Vera Karger, M.S., CCCS
Monroe, CT
vkargerslp at mac.com




On Sep 10, 2009, at 11:31 AM, rene taylor wrote:

> This is usually the result of GERD, the prevalence of which is very  
> high in
> the DD population. The mucosa of the esophagus contain mucous glands  
> that
> are expressed as foodstuffs distend the  esophagus allowing mucus to  
> be
> secreted and aid in lubrication. When this mucous tissue is bathed  
> in acid
> per reflux, the mucus produced, joined with mucus required for  
> lubrication,
> gathers above the LES and can rise as far as the pharynx. Persons with
> moderate GERD report throat clearing after a meal to clear mucus  
> ( they
> usually call it phlegm) or waking in the night because of constant  
> throat
> clearing. The incidence of pneumonia in the DD population is related  
> to the
> high incidence of reflux, commonly during sleep, rather than to
> oropharyngeal aspiration. If the mucus is particularly thick, it can  
> be a
> sign of dehydration.
>
>
> On Thu, Sep 10, 2009 at 12:00 PM, hannah.crawford <
> hannah.crawford at northumbria.ac.uk> wrote:
>
>> I have a question that I would be interested to hear the list's  
>> members
>> opinion on. I am an SLT working with adults with mental retardation  
>> in the
>> UK, but I'm sure this presentation is not confined to them.
>>
>> What do people make of patients who produce copious thick, tenuous  
>> white
>> bubbly phlegm. It often comes up after coughing at mealtimes.  
>> Sometimes this
>> phlegm is so thick and copious that staff can 'pull' it out, or  
>> patients
>> have been known to have serious choking episodes on it. Obviously  
>> as an SLT
>> I have tended to worry about this, but over time, have become  
>> fairly sure
>> that it isn't coming from the chest at all. Clinically I have found a
>> startling correlation between its presence and the presence of  
>> Helicobacter
>> Pylori, but I have wondered whether this is the answer, and if so,  
>> if anyone
>> has any robust evidence that discusses this. I have also wondered  
>> if anyone
>> has any other competing theories. I have heard other SLTs who are  
>> interested
>> in this gastro oesophageal area propose that it may be the mucus  
>> that coats
>> the oesophagus, that gets 'caught' and builds up above a stricture or
>> achalasia.
>>
>> I would be really interested and grateful to hear anyone else's  
>> opinion or
>> experiences.
>>
>> Kind regards
>>
>> Hannah Crawford
>> Consultant Speech & Language Therapist
>> Tees, Esk & Wear Valleys NHS Trust
>>
>> RCSLT Professional Advisor (ALD Dysphagia)
>>
>> Admin Block
>> Bankfields Court
>> Flatts Lane
>> Middlesbrough
>> TS6 0NP
>>
>> 07824 461422
>> 01642 283716
>>
>>
>>
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