chapter  12
Impairment of swallowing, liver, and defecation functions
ByRamar Sabapathi Vinayagam
Pages 4

“Integrated Evaluation of Disability” defines impairment in dysphagia based on variables namely risk of aspiration, postural techniques, compensatory manoeuvres adopted to minimise the risk of aspiration during swallowing and alternate feeding methods such as nasogastric feeding, feeding through gastrostomy (percutaneous endoscopic gastrostomy). Serum level of bilirubin, albumin, sodium, INR, and hepatic encephalopathy defines impairment in chronic liver failure. Neurological cause, the frequency of bowel movement, response to fibre supplements and suppositories, need for prokinetic agents and indication for colostomy are essential variables to define impairment in constipation.