GUIDE
Dysphagia: Everything You Need to Know About Chewing and Swallowing Difficulties
Dysphagia can have serious consequences for those affected, including the risk of malnutrition, dehydration, and pneumonia. It is a complex condition that requires a good understanding and a comprehensive treatment plan. This article provides insight into what dysphagia is, its causes, symptoms, treatment options, and how nutrition can play a crucial role in managing the condition.
Key Points from This Article
What Is Dysphagia?
Dysphagia, also known as chewing and swallowing difficulties, can make it hard to eat and drink adequately. Even swallowing saliva can become a challenge. The term dysphagia comes from Greek, where "dys" means difficult, and "phagein" means to eat. Dysphagia is not a disease itself but a symptom of various illnesses such as Parkinson’s disease, Chronic Obstructive Pulmonary Disease (COPD), Amyotrophic Lateral Sclerosis (ALS), and dementia, as well as several types of cancer, such as head and neck cancer.
Dysphagia can range from a mild irritation to a serious health risk. In the worst cases, it can lead to malnutrition, dehydration, aspiration pneumonia, and can even be fatal. Therefore, it is crucial to take dysphagia seriously and seek appropriate treatment.
Dysphagia in Older Adults
Dysphagia can result from aging or disease, making older adults particularly at risk of developing chewing and swallowing difficulties. It is estimated that around 50% of acute elderly patients and 50-75% of nursing home residents have dysphagia.
Several studies indicate that sarcopenia is one of the causes of dysphagia in the elderly. Sarcopenia is the age-related loss of muscle strength, mass, and function. When older individuals lose muscle mass and strength, it can affect the head and neck muscles used for chewing and swallowing.
Symptoms of Dysphagia
Symptoms of dysphagia can vary greatly from person to person. Some of the most common symptoms include:
How Is Dysphagia Diagnosed?
Diagnosing dysphagia typically begins with a thorough discussion with a doctor and a physical examination. The doctor will ask about symptoms and may perform simple tests like a water swallow test, where the patient drinks water under observation. In home care or nursing homes, occupational therapists often perform these assessments.
More advanced tests can include videofluoroscopy, where an X-ray film records the swallowing process, or endoscopy, where a flexible tube with a camera is inserted into the throat to view the esophagus. These tests help determine the cause of dysphagia and guide the best treatment plan.
What to Eat and Drink When Suffering from Dysphagia
One of the most common treatments for dysphagia is modifying diet and eating habits, making good nutrition crucial. It is important to choose foods and drinks with a consistency that is easy to swallow without using excessive energy and with a low choking risk. Avoid foods that require strong chewing abilities or have problematic consistencies, such as:
Instead, choose foods with a soft consistency, puréed foods, or foods that can easily be mashed with a fork, such as:
You can also use thickening agents, specially designed products added to liquids and foods to change their consistency and make them easier to swallow. Thickeners are available in powder or gel form and can be used for drinks, soups, sauces, and even puréed foods.
Clinical Nutrition for Dysphagia
When suffering from dysphagia, individualized nutritional therapy by a clinical dietitian can make a significant difference. This ensures a tailored plan that meets your specific needs.
You may require nutritional drinks or tube feeding to ensure you receive enough vitamins, minerals, proteins, carbohydrates, and fats to prevent malnutrition.
At Mediq, you will find nutritional drinks and tube feeding products from brands and manufacturers such as Fresubin, Nutridrink, Resource, Cenaman, Elemental, Nutricia, Fortini, Frebini, Minimax, Peptamen, and Renilon. As a customer, you can receive free and professional guidance from our experienced dietitians, who will work with your hospital, care center, or doctor to find a solution that suits you.
Practical Advice for People with Dysphagia
If you have dysphagia, here are some practical tips that can help:
Consistency Levels in Dysphagia Management: Guidance for Healthcare Professionals and Caregivers
For patients, dysphagia can increase the risk of pneumonia, impair quality of life, result in longer hospital stays, more readmissions, and higher mortality. It is therefore crucial for healthcare professionals to closely monitor respiratory complications and patients’ ability to consume calories, nutrients, and fluids.
The IDDSI (International Dysphagia Diet Standardisation Initiative) has developed a framework to adjust diets according to individual needs. It categorizes food and drink consistencies into eight levels (0–7):
For patients with dysphagia, consuming foods and drinks with the wrong consistency can lead to serious complications and greatly impact quality of life.
Sources:
Philipsen, B. B., Mortensen, H. R., & Melgaard, D. (2019). Dysfagi. Ugeskrift for Læger, 181, V09180594.Dam, G. A., Hvas, C. L., Jeppesen, P. B., Kristensen, M. B., Rasmussen, H. H., Wiis, J., et al. (2023). Klinisk ernæring (6. udg.). Munksgaard.Austbø Holteng, L. B., Frøiland, C. T., Corbett, A., & Testad, I. (2017). Care staff perspective on use of texture modified food in care home residents with dysphagia and dementia. Annals of palliative medicine, 6(4), 310–318.Niemeier, H. et al. (2017). Rammeplan: Diætbehandling af voksne med øvre dysfagi. Foreningen af Kliniske Diætister (FaKD).Arla og Kost- og Ernæringsforbundet. Underernæring – det skjulte samfundsproblem. Februar 2014.
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