Swallowing is an action many people don’t think about.
While most people are unaware of the act of swallowing, it is a complex neuromuscular process that involves multiple muscles and nerves working together to move food or liquid from the mouth, through the throat, and into the stomach.
“Swallowing is such an integral part of our lives that we don’t think about it, but when there is an issue, it quickly becomes a challenging aspect for some families,” said Kaitlin July, MD, assistant professor of Clinical Otolaryngology-Head and Neck Surgery at Monroe Carell Jr. Children’s Hospital at Vanderbilt. “Swallowing issues are often a chronic problem for which creative and multifaceted strategies and management is required. Addressing these concerns early on can vastly improve the quality of life for the patient.”
Feeding and swallowing problems, known as dysphagia, occur in an estimated 25% to 45% of normally developing children, said July.
Families struggling with dysphagia now have a more advanced clinical resource — the Complex Dysphagia Management Clinic at Monroe Carell, the only multidisciplinary, complex swallowing and feeding clinic of its kind in Tennessee. The level of care provided at this clinic is offered at similar locations across the country, with the next closest options in Atlanta and Cincinnati.
Prior to the new clinic’s opening, patients were seen by a host of specialists in the Complex Aerodigestive Evaluation Team Clinic, which focuses on patients with complex airway, pulmonary, upper digestive, sleep and feeding disorders.
Monroe Carell’s newest offering is designed to assist pediatric patients with significant swallowing difficulties as a primary concern that requires a different focus and a high level of care coordination and management. Though similar specialties are present, the focus is more specifically on swallowing.
Dysphagia is a result of various medical conditions and can lead to serious outcomes if not treated.
“When feeding or swallowing issues are complex or overlap with concern for anatomical or medical disorders, a comprehensive evaluation may be needed, for which a multidisciplinary approach and individualized care plan can be made for each child,” explained July. “Dysphagia and swallowing disorders are an underrecognized medical issue.
“We have recognized the impact this has had on people’s lives and felt it was important enough for our teams across various disciplines to come together and manage this population of patients.
“It’s an incredible feeling to transition a child off a G-tube (a surgically placed feeding tube) and see them advance, feed and swallow. It’s hugely meaningful for us and incredibly impactful for families and their quality of life.”
To provide the best options for patients, July, an otolaryngologist, and the team of gastroenterologists and speech therapists believe raising awareness about the clinic among pediatricians and health care providers is key.
“If you have a patient who is struggling with swallowing issues, and there are concerns of aspiration, and there is a need for an extra set of eyes and coordination across multiple specialties, this is a great place for an evaluation and for information on additional therapies that we offer to improve swallow function,” July said.
July anticipates the clinic will grow, but for now patients are seen by referral on two half-days each month.
“There has been a lot of eagerness and anticipation for this clinic,” said July. “Our teams are being proactive in children’s health and addressing issues earlier for a better impact and outcome. We know swallowing can be a challenging issue to face, but we are excited to be coming together to help these kids and families.”
