Dysphagia means difficulty in swallowing. Symptoms of dysphagia can vary in severity ranging from mild discomfort in the mouth or throat when swallowing to an inability to eat. Some people are able to describe the difficulty, others may not know they are at risk for swallowing problems. Untreated dysphagia can lead to malnutrition and dehydration. Diet modifications may be necessary depending on the severity of dysphagia.
Complications
If you have difficulty swallowing you may be at risk for aspiration. Aspiration occurs when foods and fluids pass through the vocal cords and enter into the airways. Large amounts of aspiration are associated with an increased risk of choking and pneumonia. Dysphagia can cause a decrease in the amount of food and fluids necessary to maintain adequate nutrition and healthy weight. Malnutrition can weaken the immune system and leave you susceptible to other illnesses. Dehydration associated with dysphagia can lead to dementia-like symptoms and general functional decline.
Symptoms
Signs of dysphagia may include taking longer to eat, swallowing several times for each mouthful of food, avoiding specific textures or tastes, sitting in a specific position such as tucking the chin down, playing with food, and eating very little. Compensatory mechanisms such as withdrawing early from meals and refusing foods or fluids are frequently methods used to help avoid social embarrassments related to the drooling, regurgitation and belching.
Management
Encouraging independent eating for as long as possible is of maximum importance. With mild dysphagia, providing a soft diet and education may be enough to provide adequate nutrition and hydration. Oral hygiene before and after meals can help to stimulate the production of saliva. As the dysphaia progresses a pureed diet may be necessary. Thickened fluids are easier to manage than liquids, so commercially prepared thickeners may be needed to encourage hydration.
Suitable Foods
For mild dysphagia suitable food recommendations include cereals such as porridge or those which have absorbed milk and have thickened. Sandwiches with moist fillings such as egg, tuna and mayonnaise. Stewed or baked fruits like apples and bananas are generally well tolerated. Meat should be tender and served with a sauce. Foods not recommended include cereals that have not been soaked in milk, soups which have not been liquidized, raw fruits and vegetables and solid chunks of dry meat. Avoid biscuits with fruit, nuts or chocolate chips. Progressive stages of dsyphagia may require semi-solid or pureed foods. Efforts should be made to make food flavorful and appear appetizing.
References
- "Nursing and Residential Care"; Recognizing and treating dysphagia can help residents maintain their dignity; A. Shepherd; October 2010
- "Medsurg Nursing"; Dysphagia: An Overview: M. Terrado PhD., C. Russell., J. Bowman.; October 2001
