Relationship between Dysphagia and Exacerbations in Chronic Obstructive Pulmonary Disease: A Literature Review

Abstract

Introduction The literature presents studies correlating chronic obstructive pulmonary disease to dysphagia and suggesting that the aspiration laryngeal phenomenon related to changes in the pharyngeal phase contributes significantly to the exacerbation of symptoms of lung disease. Objectives This study aimed to conduct a literature review to identify the relation between dysphagia and exacerbations of chronic obstructive pulmonary disease. Data Synthesis We found 21 studies and included 19 in this review. The few studies that related to the subject agreed that the presence of dysphagia, due to lack of coordination between swallowing and breathing, may be one of the triggering factors of chronic obstructive pulmonary disease exacerbation. Conclusions The review noted that there is a relationship between dysphagia and exacerbations of chronic obstructive pulmonary disease, identified by studies demonstrating that the difficulties associated with swallowing may lead to exacerbation of the disease. There was difficulty in comparing studies by their methodological differences. More research is needed to clarify the relationship between dysphagia and exacerbations of chronic obstructive pulmonary disease, making it possible to develop multiprofessional treatment strategies for these patients, catered to specific needs due to the systemic manifestations of the disease.

Oropharyngeal swallow physiology and swallowing-related quality of life in underweight patients with concomitant advanced chronic obstructive pulmonary disease

“…A higher incidence of laryngeal penetration and tracheal aspiration in COPD patients has been reported in previous studies, with the suggestion that ingested material in the airway may increase exacerbations in COPD 6. Good-Fratturelli et al reported 28% and 42% penetration and aspiration rates, respectively,5 similar to other studies 10–12.…”

“…One study reported the incidence of dysphagia associated with COPD was 85%, with laryngeal penetration and tracheal aspiration observed in 28% and 42% of subjects, respectively 5. Further, complications secondary to swallowing impairments, such as aspiration pneumonia, dehydration, and airway obstruction, have been shown to contribute to disease exacerbations 6. The negative effects of exacerbation on patient’s quality of life, physical and physiological well-being, and early mortality2 highlight the potential impact that dysphagia may have on the natural course of COPD.…”

A possible pathological link among swallowing dysfunction, gastro-esophageal reflex, and sleep apnea in acute exacerbation in COPD patients

“… 2 Swallowing dysfunction and altered reflexes with laryngeal aspiration 3 may predispose individuals to acute exacerbations, with a relative risk of 2.8 (95% confidence interval 1.5–5.0). 4 The presence of swallowing abnormalities during a stable phase of COPD was linked to a higher risk of developing exacerbations in the following year. 5 A significant proportion of individuals hospitalized with an exacerbation of COPD have a coexisting oropharyngeal swallowing disorder, 6 which may contribute to or exacerbate their disease.…”

Expanding speech pathology delegation practices: engaging Allied Health Assistants (AHAs) in dysphagia management in the acute hospital setting

“…Dysphagia is a common consequence of a number of medical conditions, as well as the normal ageing process (Coates & Bakheit, 1997;Martin-Harris et al, 2005;Meng, Wang, & Lien, 2000;Paranji, Paranji, Wright, & Chandra, 2017;Roden & Altman, 2013;Rofes et al, 2010;Sarabia-Cobo et al, 2016;Steidl et al, 2015). Given the variety of underlying conditions which may result in dysphagia, it may be classified as 'acute onset' or 'chronic/progressive.'…”

“…Dysphagia is a common complication in the acute medical setting as it is a consequence/co-morbidity of a wide range of medical conditions and interventions (Coates & Bakheit, 1997;Martin-Harris et al, 2005;Meng et al, 2000;Paranji et al, 2017;Roden & Altman, 2013;Rofes et al, 2010;Sarabia-Cobo et al, 2016;Steidl et al, 2015). A study of hospital discharge data, reviewing over 77 million acute hospital admissions, identified that while admissions related to dysphagia only accounted for 0.35%, dysphagia was associated with a 40% increase in length of stay and a significant increase in mortality risk (Altman et al, 2010).…”