Table 1 Performance descriptions for UDD symptoms
Good | Moderate | Poor | |
|---|---|---|---|
Overall | Patients are performing as expected, and do not require an intervention or evaluation. Can continue to surveillance. | Patients not performing as expected. They may need medical attention over time. Patients would receive targeted education and counseling about behavior and diet followed by re-assessment. | Frequent or severe symptoms. Requires evaluation and may need an intervention |
Dysphagia | • Able to eat along a continuum of no limitations to some difficulty with certain hard solid food (e.g., bread and meat) • Infrequent symptoms • Able to swallow all soft food • Able to swallow all liquids • No interference with daily life | • Difficulty with swallowing soft food • Able to swallow all liquids • Some interference with daily life | • Difficulty swallowing liquids or saliva • Interferes or limits daily life |
Heartburn | • No burning • No symptoms when sleeping with the head elevated • No symptoms with or without medication • No interference with daily life | • Elevating the head of the bed helps but not completely • Tolerable symptoms persist despite medication. • Aware of the symptoms but easily tolerated • Some interference with daily life | • Aspiration • Constant symptoms • Severe symptoms persist despite medication • Severe burning symptoms when sleeping with head elevated • Burning feeling in throat or behind breastbone that interferes with activities or daily life • Interferes or limits daily life |
Regurgitation | • No symptoms • No food or liquid moving in the wrong direction • No interference with daily life | • Occasional food or liquid washes up or returns to the mouth or throat • With medication, symptoms may be relieved • Lack of spontaneous regurgitation (identifiable triggers) • Predictable symptoms • Related to postural position (bending over, lying flat) or volume of food • Some interference with daily life | • Choking from fluid or ingested food that comes back to the mouth or throat • Daily occurrence • Poorly tolerated spontaneous regurgitation without identifiable triggers • Symptoms persist in spite of sitting upright or not eating before bed • Interferes or limits daily life |
Dumping - Generalized | • Experiences no or minor symptoms1 • No interference with daily life | • Experiences multiple minor symptoms1 • Some improvement with behavior changes2 • Some interference with daily life | • Experiences many minor symptoms or any major symptom1 • No improvement with behavior changes2 • Interferes or limits daily life |
Dumping - GI | • No symptoms3 • No interference with daily life | • Several symptoms3 • Some improvement with behavior changes2 • Some interference with daily life | • Many symptoms3 • No improvement with behavior changes2 • Interferes or limits daily life |
Pain | • Mild • No interference with daily life | • Moderate • Some interference with daily life | • Severe • Interferes or limits daily life |
Nausea | • No or little nausea • No interference with daily life | • Occasional episodes of no consequence • Responds to medication • Some interference with daily life | • Frequent episodes • Does not respond to medicine • Interferes or limits daily life |
Dyspnea | • No symptoms • No interference with daily life | • With exercise or intermittent • Some interference with daily life | • Interferes or limits daily activities |
Aspiration | • No aspiration • No noticeable aspiration • No interference with daily life | • Aspiration present • Symptoms are mild • No interference with daily life | • Results in dyspnea or other more severe symptoms • Interrupts or limits daily activities |