Dysphagia: evaluation and treatment.

Normal swallowing consists of a set of physiologic behaviors which result in food, liquid or other substances moving safely and efficiently from the mouth to the stomach. Dysphagic patients may have difficulty with any one or more of the anatomic or physiologic components of the oral, pharyngeal or esophageal stages of the swallow. Evaluation of the dysphagic patient should identify the anatomic or physiologic abnormalities characterizing the patient's swallow and include introduction and assessment of the efficacy of treatment strategies. Treatment may involve compensatory management, such as postural changes or enhancing sensory input, or active muscle exercise with or without the introduction of food. Speech-language pathologists have taken the lead in research on normal swallow and evaluation and treatment strategies for dysphagia.