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Aerodigestive Disorders

Signs are observations made by a third party (e.g., clinician or family member). For example, observations of coughing when someone swallows may be a sign of aspiration, and observations of changes in someone’s vocal pitch may be a sign that the vocal folds are swollen or inflamed.

Symptoms are a person’s own perception of changes in their swallowing, voice, breathing, or desire to eat or drink. Symptoms are usually described in terms of severity, location, frequency, and duration. For example, a person may notice that, recently, they have been coughing a great deal following exercise.

Signs and symptoms of aerodigestive disorders can vary depending on the specific disorder and the severity of the condition causing the disorder.

The following signs and symptoms are grouped by the function that can be affected:

Feeding and Swallowing

  • aversion, disinterest, or refusal behaviors surrounding eating or drinking
  • avoidance of certain foods and/or food characteristics
  • avoidance of eating and drinking in public
  • coughing or choking during or after eating
  • globus sensation (feeling of something stuck in the pharynx)
  • increased duration of feeding and/or mealtimes
  • increased swallowing effort
  • odynophagia (painful swallowing)
  • pharyngonasal backflow (often referred to as “nasopharyngeal reflux”)
  • poor weight gain in infants and children
  • recurrent pulmonary infections, such as pneumonia
  • regurgitation of swallowed food back into the pharynx or into the oral or nasal cavity
  • slow or uncoordinated feeding in infants and children
  • throat clearing during or after eating
  • unexplained weight loss in adults or children
  • wet breath sounds or wet vocal quality during or after eating

Voice

  • aphonia (no voicing)
  • breathiness
  • increased vocal effort
  • pain while voicing (odynophonia)
  • rough vocal quality
  • strained vocal quality
  • vocal fatigue
  • vocal pitch changes (e.g., in response to inflammation and edema)
  • weak or inadequate vocal volume

Respiration

  • chronic cough
  • discoordinated or weak voluntary cough
  • excessive mucous secretion
  • excessive sputum production
  • inability to manage oral and/or pharyngeal secretions independently
  • increased effort of breathing
  • overwhelming need to want to “take a breath”
  • pneumonia
  • rapid respiratory rate
  • recurrent respiratory infections
  • stridor (secondary to vocal fold paralysis or other airway obstruction; inspiratory or biphasic)
  • weak reflexive cough
  • wheezing

Paradoxical Vocal Fold Movement (PVFM)

  • cough and rough vocal quality before or during an episode of vocal fold adduction
  • difficulty inhaling, exhaling, or both (sole report of difficulty exhaling suggests asthma)
  • lightheadedness that resolves quickly when trigger is removed
  • stridor on inhalation (stridor for both inhalation and exhalation suggests laryngeal obstruction)
  • sudden adduction of the vocal folds induced by triggering stimuli, such as activity, stress, or environmental irritants
  • sudden and total loss of voice
  • tightness in the throat

Chronic Cough

  • productive (wet) or nonproductive (dry) cough
  • cough lasting more than 8 weeks in adults and more than 4 weeks in children

For more detailed information about the signs and symptoms of aerodigestive disorders, see, for example, Andrews (2006), Ashland and Hersh (2009), Coyle (2010), Dinwiddie (2004), Ibrahim et al. (2007), Jadcherla (2012), Matsuo and Palmer (2008), Morice (2004), and Morris et al. (2006).

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