Dysphagia and MIP

Prevalence and aetiology – Medication Intake Problems (M.I.P.) are defined as problems swallowing solid oral medication in the proper galenic form with an appropriate swallowing vehicle.
• Prevalence: a survey shows that 40% of the population suffer from M.I.P. Both men and women of all ages.
• Aetiology:
- Without a physiological or pathological cause:
1. Polypharmacy often in combination with several intakes per day.
2. Big pills or capsules.
3. Non-smooth or hygroscopic tablets.
4. Strange form of pill or tablet.
- Xerostomia – often related to medication (ex. antidepressants, antipsychotics, diuretics and antihistaminics).
- Neurological disorders (ex. CVA, Parkinson, ALS, dementia).
- Anomalies in the ORL area (ex. carcinoma) as well as the associated radio therapeutic treatment.
- Various: anxiety, stress, certain food, wearing dentures.
Dysphagia is the medical term to describe difficulty in swallowing. For clinical purposes, dysphagia can be classified into two distinct categories: oropharyngeal dysphagia, and oesophageal dysphagia.
Oropharyngeal dysphagia is the inability to initiate the act of swallowing. It is a ‘transfer problem’ due to impaired ability to transfer food from the mouth to the upper oesophagus. On the other hand, oesophageal dysphagia is a ‘transport problem’ and is defined as the sensation of difficult passage of solids from the mouth to the stomach.*
*Aging and the Gastrointestinal Tract, Volume 32; Volume 2003 edited by Alberto Pilotto, Peter Malfertheiner, Peter R. Holt
Dysphagia, as with all medical conditions, is characterised by a spectrum of severity. Some patients may only experience slight discomfort or difficulty swallowing, while others experience severe difficulty and require the assistance of a Doctor or Speech and Language Therapist to advise of the most appropriate treatment to manage their condition.