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19 Aug 2012

A simple bodily function that most of us pay no attention to – swallowing – has become a prime focus of doctors at Fortis hospital while helping patients recuperate.

Dysphagia or difficulty in swallowing is a common disorder that affects patients with severe head injuries or brain stroke. This results in greater health care costs and other complications like dehydration, malnutrition and pneumonia.

While swallowing therapy is given equal importance during a patient’s treatment abroad, it is steadily picking up in India.

Dr Girish Nair, neurologist at Fortis hospital said, "We take swallowing for granted but for patients who find this difficult, it is a big problem that extends their stay in the hospital. Our main aim is to reduce the pain of an extended stay in the hospital and to make patients independent, at least while eating."

Fortis’ neurology and ENT department formed a special team on an experimental basis a year ago and has helped 100 patients so far. The team consists of a neurologist, an ENT doctor, a radiologist, a dietician and nursing staff.

"We have to teach these patients the art of swallowing that they forget because of their illness. Our therapy includes measures like tongue training and chin tuck exercises," said Dr Sanjay Bhatia, ENT surgeon at Fortis. He added that along with the nurses, even the patient’s relatives are trained so that therapy is given to the patient constantly.

Around 27% to 50% of stroke patients face difficulties swallowing. Dr PP Ashok, neurologist at PD Hinduja Hospital said, "We generally keep the patient on a rice tube which is traumatic and discomforting to the patient as he has to change the tube every seven days. Alternately, we use a percutaneous gastrostomy tube which is not visible to others and inserted surgically that last 6-8 months." While these procedures do help in aiding nutrition, there is still a high risk of infection and issues of aspiration.

Dr Nair cited a recent success case when he said, "A woman had suffered a massive brain stroke and her entire left side was paralysed. She couldn’t speak and had problems swallowing. Within a week of our therapy, she was able to eat herself and we discharged her."

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