Among the day-to-day challenges that stroke survivors can experience is difficulty eating or drinking. A stroke may weaken or affect the coordination of the swallowing muscles or limit sensation in the mouth and throat, leading to what is called dysphagia. Dysphagia, or swallowing problems, may occur in up to 65 percent of stroke patients, according to the American Stroke Association.
A person swallows approximately 600 times per day, so swallowing difficulties can severely disrupt day-to-day functioning. People with dysphagia are at risk for medical complications including dehydration and risk of aspiration (food or liquid entering the airway), which can cause pneumonia and chronic lung disease. Dysphagia also can result in poor nutrition, which can affect a person’s ability to recover, as well as their social interactions and quality of life. Eating is a central component to many family and social gatherings, and a person experiencing problems may avoid these events — leading to isolation and feelings of loneliness.
The good news is that dysphagia need not be a permanent complication after stroke. Effective treatment is available. The first step is an assessment by a speech-language pathologist — the primary professionals who treat swallowing disorders. Most often, a patient will see a speech-language pathologist in the acute care unit or at their hospital bedside for an evaluation. If swallowing difficulty is confirmed, treatment will occur in the hospital and may continue in rehab and even after a patient returns home.
Treatment may take a variety of approaches, depending on a person’s symptoms and the nature of the problem. A speech-language pathologist may prescribe specialized exercises to improve muscle movement, suggest positions or strategies to help the person swallow more effectively, or recommend specific food and liquids that are easier and safer to swallow.
If treatment includes a modified diet of food and liquids (generally prepared to a recommended texture), the goal is for this to be a temporary situation while the person is on the road to recovery. Patients should expect the least-restrictive diet, with the end goal of returning to enjoying the same food they ate prior to stroke.
There are a variety of strategies that can make eating safer for stroke survivors. These include:
1. Go small
Take small bites of food and small sips of liquids.
2. Pace yourself
Take one bite or sip at a time. Swallow completely before taking another bite.
3. Be deliberate
Try to swallow hard when you are eating, like you are swallowing a large pill.
4. Eliminate distractions
Focus on eating — turn off the TV and don’t talk.
5. Change your diet
Try softer foods if you are having trouble chewing.
6. Hold your posture
Sit up for a while after eating to make sure the food goes down.
7. Clean your mouth
After eating, brush your teeth and rinse your mouth.
Always check with a speech-language pathologist before trying these techniques.
