ABSTRACT
This chapter describes the medical condition of dysphagia. Dysphagia, or difficulty in swallowing, occurs in around 10–12% of hospice patients. Dysphagia may occur in neurological illness such as motor neuron disease, or may be the result of a benign stricture, but the main malignant causes are as follows: head and neck cancer, mediastinal nodes compressing the oesophagus, oesophageal cancer and stomach cancer. Dilating a malignant stricture using endoscopy takes a few minutes and can improve swallowing. Patients on sustained-release medications must have their medication reviewed and should be aware that they must not crush the tablets. Nasogastric feeding is of value mainly if patients can swallow some food and fluids, and it is used for short-term nutritional support. When it becomes difficult even to swallow saliva, the use of scopolamine patches every third day may reduce salivation and offer some symptomatic relief.
