Symptom indices for dysphagia assessment and management

Abstract

Dysphagia is a symptom and not a disease. The symptom can range from the feeling of a simple lump in the throat with no objective physiologic findings of a swallowing impairment to profound dysfunction necessitating complete reliance on non-oral nutrition via tube feeding. Etiology may offer some indication of the expected level of dysfunction but even in patients suffering the same underlying disease or disorder, symptoms do not always correlate with the level of impairment. Clinicians need to be able to quantify the severity of dysphagia and estimate the effect on quality of life that this symptom causes. Patient reported outcome measures (PROMs) offer a reproducible, safe, and cost-effective method of estimating dysphagia severity, monitoring change over time, and assessing response to treatment. In order to improve the treatment of dysphagia, we must first be able to measure the severity of the symptom. This purpose of this chapter is to review some of the currently available PROMs in the assessment and management of dysphagia and reflux disease.