The Joy McCann Culverhouse Center for Swallowing Disorders stands as a premier national and international referral center for patients with complex esophageal conditions that many other hospitals are not equipped to effectively manage. Our multidisciplinary team includes board-certified gastroenterologists, esophageal surgeons, speech-language pathologists and advanced practice nurses who specialize in swallowing disorders and esophageal conditions. As one of the few endowed swallowing centers in the United States, our center of excellence was established through a generous gift from the Culverhouse family, former owners of the Tampa Bay Buccaneers.
About Swallowing Disorders
Also known as dysphagia, the term “swallowing disorders” refers to a range of conditions that interfere with the ability to swallow food, liquids or even saliva. Difficulty swallowing can result from issues with the muscles or nerves involved in the swallowing process, leading to challenges in safely moving food from the mouth to the stomach. These issues may arise from a neurological condition, structural abnormality or esophageal injury. Symptoms of dysphagia include choking, coughing and the sensation that food is stuck in the throat.
Swallowing disorders can be complex and often involve multiple bodily systems, such as the nervous, muscular and structural components of the esophagus and throat. Additionally, improper swallowing can lead to serious complications, such as aspiration, choking, malnutrition and dehydration. For these reasons, dysphagia requires advanced care, including a precise diagnosis and specialized treatment to address the underlying cause and improve the ability to swallow safely and efficiently.
Why Choose TGH
Led by a Castle Connolly “Top Doctor,” the respected specialists in the Joy McCann Culverhouse Center for Swallowing Disorders are widely known for their expertise in managing complex esophageal conditions, gastrointestinal motility disorders and achalasia. We are proud to treat more eosinophilic esophagitis (EOE) patients than any other hospital in the state. During weekly conferences, our gastroenterologists, esophageal surgeons and speech-language pathologists collaborate closely with pulmonologists, otolaryngologists (ENTs), neurologists and other specialists at TGH, ensuring that each patient benefits from multiple expert opinions in a single location
Swallowing Disorders Treated
The multidisciplinary team in the Joy McCann Culverhouse Center for Swallowing Disorders treats a full range of esophageal conditions, including:
- Achalasia – The lower esophagus muscle fails to relax properly, causing difficulty swallowing and regurgitation of food.
- Aerophagia, supragastric belching and gastric belching – Excessive swallowing of air can lead to belching, bloating and discomfort in the stomach and esophagus.
- Barrett’s esophagus – Chronic acid reflux can cause harmful changes in the esophageal lining, increasing the risk of esophageal cancer.
- Complex esophageal strictures – Narrowing of the esophagus caused by scarring or inflammation can cause difficulty swallowing food and liquids.
- Eosinophilic esophagitis – A common allergic inflammatory condition of the esophagus.
- Esophageal cancer – Cancer that originates in the esophagus can affect swallowing and potentially cause pain, weight loss and difficulty eating.
- Extra-esophageal manifestations of GERD – Symptoms of gastroesophageal reflux disease can affect areas beyond the esophagus, such as the throat, lungs and ears.
- Functional dysphagia – Dysphagia that occurs without a clear structural or mechanical cause may result from dysfunction of the muscles involved in swallowing.
- Lichen planus of the esophagus – A frequently misdiagnosed esophageal mucosal inflammatory disorder, lichen planus causes painful sores to develop in the esophagus, which may lead to dysphagia.
- Oropharyngeal dysphagia – Difficulty swallowing that originates in the mouth and throat may be caused by nerve or muscle dysfunction.
- Post-surgical swallowing problems – Swallowing difficulties can arise following surgery involving the head, neck or esophagus.
- Swallowing disorders from neurological conditions – Amyotrophic lateral sclerosis (ALS), brain injuries, multiple sclerosis, myasthenia gravis and stroke can affect the muscles and nerves involved in swallowing.
Testing and Diagnostics for Swallowing Disorders
Swallowing disorders are typically diagnosed through a combination of medical history review, physical examination, lab tests, imaging studies and procedures. This comprehensive assessment can help a physician pinpoint the underlying cause of dysphagia, whether it is related to a structural issue, muscular problem or neurological condition. Diagnostic testing is essential to evaluate the function of the esophagus, the effectiveness of the swallowing process and the presence of any blockages or abnormal tissues.
Common Testing Used to Evaluate Swallowing Disorders and Reflux:
- Esophagogastroduodenoscopy (EGD) – During this minimally invasive procedure, a physician will use a flexible scope to visually examine the esophagus, stomach and upper small intestine, checking for inflammation, strictures and abnormal growths.
- High-resolution esophageal manometry – A leading tool in the assessment of esophageal motor disorders, this noninvasive test measures the pressure and movement of the esophagus during swallowing, providing valuable insights into its muscular function.
- Bravo 96-hour pH test – Also known as a wireless esophageal pH test, this lab-based monitoring test involves the placement of a small capsule with a pH sensor in the esophagus to measure acid levels over 96 hours.
- Impedance pH testing – A catheter is placed in the esophagus to measure acidity levels and fluid movement over time. The data collected is analyzed in a lab to help diagnose GERD and other reflux-related issues.
Testing Performed by our Speech Pathology Team:
- Fiberoptic endoscopic evaluation of swallowing (FEES) – A speech language pathologist will guide a thin, flexible tube with a light and camera attached (endoscope) through the nose and into the middle of the throat. While the patient swallows small amounts of food and liquid, the endoscope will record the examination.
- (1 importance) Modified barium swallow (MBS) – During this specialized X-ray procedure, the patient will swallow various food and liquid consistencies mixed with a barium contrast substance while images are recorded. As the substance travels from the mouth to the esophagus, the physician can observe the structures and muscles involved in swallowing.
- Laryngeal videostroboscopy – A speech pathologist or physician will insert an endoscope through the nose or mouth, allowing them to view the vocal folds, which vibrate to produce sound. Using the endoscope as a strobe light, the practitioner will capture a series of images, which may reveal weakness, stiffness, irregular movement or incomplete closure of the vocal folds.
Support Services for Patients With Swallowing Disorders
Supportive services complement medical care by addressing the myriad emotional, nutritional and practical challenges associated with swallowing disorders, helping patients and their families manage these complex conditions more effectively. In the Joy McCann Culverhouse Center for Swallowing Disorders, these vital services are delivered by a multidisciplinary team, ensuring that each patient receives personalized support tailored to their individual needs. We offer:
- Speech-language therapy – Specialized therapy sessions with a speech-language pathologist can focus on improving swallowing mechanics and ensuring safe eating and drinking.
- Nutritional counseling – A dietitian can work with a patient to develop meal plans that meet their nutritional needs while accommodating their swallowing limitations.
- Psychological support – A counselor or therapist can help a patient cope with the emotional and psychological effects of living with a swallowing disorder, such as anxiety or depression.
- Support groups – Group sessions provide opportunities for patients and their families to connect with others who are facing similar challenges, providing a platform for sharing experiences, advice and encouragement.
- Caregiver education – Specialized training for a caregiver can include guidance on meal preparation, feeding techniques and recognizing signs of swallowing-related complications.
- Assistive devices – Access to tools such as specialized drinking cups, straws and eating utensils can make eating and drinking easier for a patient with physical or coordination challenges.
- Social work services – A social worker can assist a patient and their family in navigating the healthcare system, accessing resources and managing financial or insurance-related concerns.
These services can provide essential support, foster independence and improve the outcome of a patient with a swallowing disorder.
Research and Clinical Trials
In addition to delivering world-class patient care, the Joy McCann Culverhouse Center for Swallowing Disorders is dedicated to advancing research and promoting education. We are often called upon to educate specialists across the United States, and we actively teach students, residents, fellows and patients, fostering a deeper understanding and awareness of complex swallowing disorders. Through extensive research and firsthand experience, our team is continually expanding its knowledge base, driving both innovation and excellence in patient care.