Current Treatment Options in Gastroenterology

, Volume 15, Issue 3, pp 382–396 | Cite as

Dysphagia in the Elderly

  • Scott M. Smukalla
  • Irina Dimitrova
  • Jeremy M. Feintuch
  • Abraham Khan
Intractable Disease in the Elderly: When Conventional Therapy Fails (S Katz, Section Editor)
  • 384 Downloads
Part of the following topical collections:
  1. Topical Collection on Intractable Disease in the Elderly: When Conventional Therapy Fails

Opinion Statement

Dysphagia is a common problem in the elderly population with an especially high prevalence in hospitalized and institutionalized patients. If inadequately addressed, dysphagia leads to significant morbidity and contributes to decreased quality of life. Dysphagia can be categorized as emanating from either an oropharyngeal or esophageal process. A disproportionate number of elderly patients suffer from oropharyngeal dysphagia with a multifactorial etiology. Historically, treatment options have been limited and included mostly supportive care with a focus on dietary modification, food avoidance, and swallow rehabilitation. Nascent technologies such as the functional luminal imaging probe (FLIP) and advances in esophageal manometry are improving our understanding of the pathophysiology of oropharyngeal dysphagia. Recent developments in the treatment of specific causes of oropharyngeal dysphagia, including endoscopic balloon dilations for upper esophageal sphincter (UES) dysfunction, show promise and are expected to enhance with further research. Esophageal dysphagia is also common in the elderly and more commonly due to an identifiable cause. The full breadth of treatment options is frequently unavailable to elderly patients due to comorbidities and overall functional status. However, the increasing availability of less invasive solutions to specific esophageal pathologies has augmented the number of treatment options available to this population, where an individualized approach to patient care is paramount. This review focuses on the evaluation and management of dysphagia in the elderly and delineates how standard and novel therapeutics are contributing to more nuanced and personalized management.

Keywords

Oropharyngeal Esophageal Dysphagia Upper esophageal sphincter Lower esophageal sphincter Dilation 

Notes

Compliance with Ethical Standards

Conflict of Interest

Scott M. Smukalla, Irina Dimitrova, and Jeremy M. Feintuch declare that they have no conflict of interest.

Abraham Khan is on the speaker bureau for EndoGastric Solutions in 2017. This company does work with GERD, which is a topic covered in minor detail in this paper.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Scott M. Smukalla
    • 1
  • Irina Dimitrova
    • 2
  • Jeremy M. Feintuch
    • 3
  • Abraham Khan
    • 1
  1. 1.Department of Gastroenterology, Center for Esophageal DiseaseNYU School of MedicineNew YorkUSA
  2. 2.Department of MedicineNYU School of MedicineNew YorkUSA
  3. 3.NYU School of MedicineNew YorkUSA

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