What is Dysphagia?
This is when a person finds it difficult to chew and swallow foods and/or liquids. There are 2 types of dysphagia and these in turn can cause major weight loss and malnutrition.
1) Esophageal dysphagia – food or liquid stopping in the esophagus, usually caused by acid reflux which over time causes inflammation of the esophagus, resulting in the narrowing of this tube [this narrowing is called a stricture].
Less frequent causes are cancer, certain muscle disorders and a hiatus hernia. A person can actually feel the food or liquid stopping in the middle/lower part of their chest, other symptoms are – chest discomfort and chest pain. Medical treatment would be the dilation of this tube [esophagus]
2) Oropharyngeal dysphagia – difficulty in starting the swallowing process [including moving the chewed food to the back of the mouth]. this condition is usually caused by brain or nerve disorders like: cerebral palsy, a stroke, multiple sclerosis, Parkinson’s and Alzheimer’s diseases, cancer involving the neck/throat, dental disorders, a blow to the neck region and a blow to the brain.
There are many symptoms for this condition, these include – inability to suck from a straw, coughing during and after a meal, drooling and a gurgling sound when the person tries to speak. Medical treatment would be done by a combined force of – physicians, registered dietitian, psychologist, speech pathologist and occupational therapist, once the condition is correctly diagnosed.
Nutritional needs
This is the most important part of any treatment for dysphagia – ensuring the patient gets the right amount of nutrition and liquids while making sure that nothing gets into the lungs [causing pneumonia].
1) Liquids – very essential in every ones diet as it maintains a persons body functions. A healthy person needs to consume at least 6 to 8 glasses of water a day, patients with this medical problem can find it difficult to swallow this thin liquid, therefore the caregiver needs to thicken this fluid [milkshake, soups etc] to assist with the swallowing and ensure a good intake of fluids daily.
2) Calories – patients find it difficult and tiring enough to swallow food, without the added problem of having to worry about eating enough calories as well. To solve this problem a caregiver can fortify any foods the patient does manage to eat.
* Make up some fortified milk by adding 1 cup of powdered milk to a quart of milk, add this to all foods that go well with milk [milkshakes, puddings, soups and sauces] as it is now very high in protein.
* add margarine, honey, sugar, pureed baby food and jelly to foods suited to these additions, this will add calories and assist with the daily calorie intake
* baby fruit juices [strained] added to cooked cereals and milkshakes will assist with adding nutrition into the patients diet
* all pureed baby meats and vegetables [stained] are good as additions into soups, gravies and sauces, this will increase the nutritious value of the selected foods
Guidelines for safe swallowing
Though not applicable to all sufferers, these few tips will help with easing the swallowing process:
* eat slowly – ensure you chew your food properly and try to only eat one food at a time – do not mix different foods on your fork
* small amounts – take small amounts [about a teaspoon full] of food at a time
* sit in a upright position at all times – do not sit on the couch to eat, rather sit in a straight back chair close to the dining room table
* avoid talking as you will need to concentrate
* eat in a relaxed environment wherever possible
* avoid distractions while eating – like watching TV
* do not mix liquid with solid food in your mouth [unless instructed to do so by your medical team] and eat on the stronger side of your mouth if you have suffered from a stroke
* to assist with swallowing you might want to try tucking your chin into your chest and bending the body slightly forward [this also assists in preventing foods from going into your airway]
* check the insides of your cheeks after each meal to ensure no food has been ‘pocketed’
* do not lie down after a meal, rather stay sitting in a upright position for the next 45 minutes or so
Hopefully you will find that some of the tips above do alleviate your swallowing problem and your health should improve once you are eating and drinking properly.
Remember – as with all medical conditions that can affect your health, to consult your doctor.