Swallowing problems are common for MS patients, review study finds

Nearly half of multiple sclerosis (MS) patients experience swallowing difficulties, which is notably higher than rates seen in the general population, according to a recent review study and meta-analysis.

Because swallowing problems, or dysphagia, can lead to serious, sometimes life-threatening, complications, it is important for patients to be routinely monitored for this symptom and potential complications.

The study overall offers “insight into the importance of routine and systemic checkups in MS patients in an effort to prevent the progression of severe comorbidities [co-existing conditions],” researchers wrote.

The review study, “Prevalence of dysphagia in patients with multiple sclerosis: A systematic review and meta-analysis,” was published in the Journal of Clinical Neuroscience.

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Dysphagia can lead to weight loss, dehydration, and other complications

MS lesions can impact the function of muscles required for proper swallowing, contributing to relatively high rates of dysphagia among MS patients.

These swallowing problems can lead to weight loss, dehydration, and bad breath, in addition to life-threatening complications such as choking or aspiration pneumonia — an infection caused by food being inhaled into the respiratory tract instead of properly swallowed.

Dysphagia can also have a significant negative impact on quality of life and contribute to mental health problems surrounding eating and drinking.

Still, the exact prevalence of dysphagia, and potential risk factors contributing to this symptom in MS, have not been established.

“Identifying dysphagia in the early stages can help reduce its consequences and apply better preventive measures to stop the progression of symptoms in those at risk,” the researchers wrote.

To get a better estimate of how prevalent dysphagia is in MS, researchers in Iran conducted a systematic review of studies published up to May 2022. The analysis included 54 studies from countries worldwide, which cumulatively involved 11,266 MS patients.

Ultimately, we need to focus on the management of dysphagia among MS patients in an effort to prevent its catastrophic side-effects.

Nearly 50% of MS patients reported difficulties in swallowing

Overall, 5,047 patients, or 44.8%, were reported to have dysphagia. Still, rates varied substantially between studies, ranging from 9% to 100%.

The researchers noted that different studies evaluated the presence of dysphagia in different ways. For example, while some studies used an instrument to measure swallowing, like an endoscope, others used screening questionnaires or other types of clinical exams.

To account for potential effects of different measurement strategies, rates of dysphagia were examined in four subgroups, divided by their diagnostic method: instrumental, screening questionnaire, clinical examination, or other.

Instrumental approaches had the highest rates of dysphagia (65.7%), followed by screening (43.2%), clinical exam (34.8%), and other (29%).

Overall, the findings indicate that the prevalence of dysphagia in MS patients is “significantly higher” than in the general population, the researchers wrote.

“Ultimately, we need to focus on the management of dysphagia among MS patients in an effort to prevent its catastrophic side-effects,” the team added. “More research is required to enlighten the ambiguity surrounding dysphagia management.”

Still, the analysis lacked information about different types of dysphagia and the treatments patients may have been receiving. These are areas that require additional research, the team noted.