Newspaper Page Text
10A
JULY 8 1999
MCG PEDIATRIC RADIOLOGISTS STUDY CHRONIC COUGHERS
Improper swallowing could
lead to respiratory problems
he Medical College of Geor
gia Children’s Medical Cen
terisspending an extra few
seconds of an X-ray procedure to
diagnose and treat swallowing
problems that otherwise might
plague children for years.
When Dr. Maria-Gisela
Mercado-Deane joined the CMC
as a pediatric radiologist in 1993,
she suspected that children with
chronic respiratory problems
might not completely close offtheir
airway when swallowing. The
result is chronic coughing - or
worse, desensitization to the dis
comfort of swallowing into the
airway. Children who become
desensitized may fail to cough,
which can result in problems such
as pneumonia or choking.
“Coughingis your body’s mecha
nism to avoid respiratory prob
lems,” said Dr. Mercado-Deane.
“Those whofrequentlydon’t cough
when they should risk pulmonary
disease.”
Some children with swallowing
difficulty go to the other extreme;
rather than ignoring the discom
fort, they avoid it altogether by
refusing to eat.
But despitethe potential of swal
lowing problems to create such
havoc, children with .such diffi
culty often suffer for years before
the problemis uncovered. Yet the
disorderisdiagnosable and treat
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able, assuming that radiologist
know what to look for.
Children with respiratory prob
lems are often referred to radiolo
gist for X-rays of their upper-gas
trointestinal functioning. Radiolo
gists are trained to look for signs
of reflux - stomach contents flow
ing back to the esophagus, which
is a common cause of respiratory
problems. Dr. Mercado-Deane
decided toseize the opportunity to
also check the child’s swallowing
function.
“I thought it was important
when doing these X-rays to pay
more attention to the swallowing
mechanism,” she said. “I think
swallowing, along with reflux, con
tributestorespiratory symptoms,
so we’re trying to diagnose and
treat them together.”
Though swallowing seems natu
ral as breathing, it is actually a
complex function requiring the
coordination of several muscles
and nerve pathways, Dr. Mercado-
Deane said. The body is designed
to handle it with ease; for in
stance, babies’ inability to chew
ensures the gradual maturation
of their swallowing mechanism.
Likewise, their chubby cheeks
help them nurse. As children
begin chewing rather than suck
ing, their cheeks help them nurse.
As children begin chewing rather
than sucking, their cheeks thinin
Living
response, and their swallowing
mechanism has matured suffi
ciently to begin eating solid foods.
But the system doesn’t always
work as intended. Children at
risk for swallowing problems in
clude premature infants, neuro
logically impaired children, chil
dren with any chronicillness and
children who have been fed
through a tube for a long period.
Dr.Mercado-Deaneis particularly
vigilant about screening these chil
dren for swallowingdifficulty. But
the disorder can plague any child,
so she checks the swallowing
mechanism of every child referred
to her for an upper-gastrointesti
nal X-ray. “It only adds an extra
minute or two to the procedure,”
she said.
are referred to CMC speech lan
guage pathologists. Several tech
niques are available to help chil
dren overcome swallowing disor
ders. Forinstance, older children
can be trained to tuck their chins
toward their chests when swal
lowing tohelp shut offthe airway.
Parents of infants with swallow
ing difficulty learn to take three
second breaks after every third
suck of a breast or bottle to ease
swallowing. Speech language pa
thologists also experiment to de
termine the food consistency an
infant can most easily tolerate.
“As the baby grows, his oral
motor skills will improve, but in
the meantime, he may need
thicker food,” said CMC speech
language pathologist Andrea
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