Dysphagia

If undiagnosed, dysphagia can lead to inadequate food and fluid intake, impaired nutritional status, chest infections, sepsis and pneumonia. Avoidance of eating may lead to social isolation^1,5.

Modification of the consistency, temperature and/or taste of liquids and food may help to maintain or improve the nutritional status of patients with dysphagia³. When managing people with dysphagia, healthcare professionals with relevant skills and training in the diagnosis, assessment and management of swallowing disorders should consider (amongst other factors) the risks and benefits of modified oral nutrition support and/or enteral tube feeding³.

Nutilis Clear is a xanthan gum based food and fluid thickener for the dietary management of dysphagia and can be used to modify the texture of both food and fluids. Nutilis Clear is designed to maintain the normal appearance of fluids. It has amylase resistant features to protect against the action of amylase, in order to help ensure a safer swallow by maintaining correct consistency in the mouth.

References

1. Cook IJ, Kahrilas PJ. AGA technical review on management of oropharyngeal dysphagia. Gastroenterolgy 1999; 116: 455-478.
2. Kuhlemeier KV. Epidemiology and dysphagia. Dysphagia 1994; 9: 209-217.
3. National Institute for health and Clinical Excellence. Nutrition support in adults: oral nutrition support, enteral tube feeding and parenteral nutrition. Clinical Guideline 32. NICE;
4. 2006.Ekberg O, et al. Social and psychological burden of dysphagia: its impact on diagnosis and treatment. Dysphagia 2002; 17: 139-146.
5. Odderson IR, et al. Swallow management in patients on an acute stroke pathway: quality is cost effective. Arch Phys Med Rehabil 1995; 76: 1130-1133.

Medical Nutrition

Dysphagia is the term used to describe a difficulty with swallowing foods and liquids. Dysphagia may occur when a disease or it's treatment affects the muscles or nerves needed to swallow.

A significant proportion of stroke patients experience dysphagia¹. It can also be associated with conditions like multiple sclerosis, Parkinson’s disease and dementia.²

Dysphagia can impact on a person's ability to consume adequate nutrition for a number of reasons, including:

• The time taken to eat meals increases
• Self-restriction due fear of choking
• Loss of enjoyment and the social aspect of eating
• A dislike for texture modified food and fluids

As a result of these nutritional challenges, people who experience dysphagia can find it hard to get the nutrition they need, and malnutrition and dehydration can occur.

How medical nutrition can help 

Good nutrition is important to avoid malnutrition and dehydration. Providing a variety of foods that have an appetising appearance and including additional energy, protein, vitamins and minerals where possible can help to optimise nutritional intake. Providing a range of hot and cold drinks throughout the day can help to prevent dehydration.

Ensuring food and fluids are the correct texture is essential in the management of dysphagia. Food and fluid thickeners can be used to thicken drinks and pureed meals to the recommended consistency that has been prescribed by the speech and language therapist (SLT).

Healthcare professionals may prescribe pre-thickened oral nutritional supplements for those with dysphagia who cannot get adequate nutrition from diet alone. They come in a range of flavours and provide additional energy, protein, vitamins and minerals.

1. Martino R, Foley N, Bhogal S, et al. Dysphagia after storke: incidense, diagnosis and pulonary complications. Stroke. 2005;36:2756-63
2. RCSLT. RCSLT resource manual for commissioning and planning services of slcn: Dysphagia. 2014. Accessed via http://www.rcslt.org/speech_and_language_therapy/commissioning/dysphagia_manual_072014
3. Felt P.Nutritional management of dysphagia in the healthcare setting. Healthcare Cateres international. 2006;1:11-43