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  6. TREATMENT OF DYSPHAGIA (Food in dysphagia)

TREATMENT OF DYSPHAGIA (Food in dysphagia)

In those with swallowing difficulties or dysphagia, an appropriate diet requires a change in the texture and consistency of the food. This modification should be done for both liquids and solid foods, depending on the type of dysphagia that the patient presents.

did-you-know-adapting-food-textures-prevent-aspirations

Although the diet for people with swallowing difficulties or dysphagia must take into account the individual characteristics of each patient, it should generally follow these characteristics:

  • Foods should be crushed into uniform or homogeneous textures, while avoiding thick textures that contain lumps, bones, thorns, filaments or seeds of fruits and vegetables.
  • Consistency of foods should be thick, but with a smooth and uniform texture. Avoid double textures, such as noodle soups, kiwi smoothies or strawberries, etc.
  • Consistency is wet and slippery to avoid causing food residues in the throat.
  • Cohesive consistency: does not divide or fragment easily
  • Does not stick to the palate, like mashed potatoes.
  • Any liquid or sauce added is as thick as the puree itself.

foods-to-avoid-if-i-have-swallowing-difficulties

What steps should be taken when preparing SOLID foods for patients with dysphagia? 

Use dessert spoons when feeding to avoid swallowing large amounts of food at one go. Avoid using straws and feeding syringes when feeding patients with swallowing difficulties.

  1. Select the type of foods carefully- try to avoid those listed above. 
  2. Avoid nutrient loss that occurs through certain cooking methods:
    • Bear in mind that cooking methods involving large amounts of water, such as boiling, results in loss of vitamins and minerals that are caused by dilution in the cooking water, thereby reducing the nutritional value of the food. Try steaming or microwaving instead. 
  3. Shred food right before eating it, otherwise keep the shredded food in the refrigerator.
  4. After crushing foods, use a colander or sift to further ensure that a uniform texture is achieved. Avoid the presence of lumps, bones, thorns or filaments.
  5. Maintain proper hygiene to avoid contamination. Shredded foods are considered to have high microbiological risk
  6. Include as much variation of food in the diet as possible.
  7. Milk or sauces can be added to achieve smooth textures.
  8. Ensure proper presentation of dishes. Low appetite can lead to reduced food intake and subsequently malnutrition. 
  9. It is not recommended to add more liquid than necessary during crushing of food since this increases its volume and thus reducing its nutrient density. In people with dysphagia, it is advisable to use low-volume, nutrient-concentrated diets to meet their nutritional needs.  
  10. Remember that you must always follow good healthy eating practices:
    • Make at least 4 meals a day: breakfast, lunch, snack and dinner. The ideal is 5 meals a day, with a mid-morning snack.
    • Do not snack excessively between meals.
    • Eat slowly and allow sufficient time to finish meals.
    • Include a large variety of food in the diet. 
    • Limit the consumption of sugars and animal fats.
    • Prepare attractive and visually appetizing dishes.
    • Be cautious with candies: they produce a lot of saliva that can pass into the airways if not swallowed properly.

    What steps should be taken when preparing LIQUIDS for patients with dysphagia?  

    • Any liquids, such as milk, coffee, soft drinks, wine, water, etc., must be adapted or modified before consuming.
      • Avoid liquids with pulp, such as un-strained fruit juices, because fruit pieces may be retained in the throat.
    • Liquids can be thickened by using commercial products. In this case, the manufacturer's instructions must be carefully followed in order to prepare the recommended consistencies (IDDSI Level 1 to 4). Consult a healthcare professional about the most appropriate level for you.
    Alimentacion dysfagia_Central2
     

    If your swallowing does not improve even after trying these steps, consult a healthcare professional for assessment and proper treatment. 

    Alimentacion dysfagia_Central2

     

    Recommended bibliography:
    • Clavé Civit P, García Peris P. Guide to diagnosis and nutritional and rehabilitative treatment of oropharyngeal dysphagia. Ed. Glosa, 2011
    • Nila Ilhamto. In-House Pureed Food Production in Long-Term Care: Perspectives of Dietary Staff and Implications for Improvement. J Nutr Gerontol Geriatr. 2014; 33 (3): 210-28.
    • Rocamora JAI et al. The modified texture menu; nutritional value, digestibility and contribution within the menu of hospitals and nursing homes. Nutr Hosp 2014; 29 (4): 873–879
    • Velasco C, et al. Food technology and evolution in modified texture foods; from crushed or dehydrated to current products. Nutr Hosp 2014; 29 (3): 465–469

     

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