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Nutrition care process for dysphagia
What
The reduced ability to swallow, caused by neurological or structural damage, leading to an interference with the efficiany that food and liquid move from the mouth to the stomach. |
Causes
Mechanical |
Neurological |
Psychological |
Oesophageal stricture |
Stroke |
Globus Hystericus |
Oesophageal spasm |
Parkinson's |
Severe anxiety |
Cancers in the head, neck and oesophageal areas |
Motor neurone disease |
Severe depression |
Cancer treatments including radiotheraphy, surgery in the neck and head area |
Head injury |
Pharyngeal pouch |
Multiple sclerosis |
Injury or surgery to the tongue, lips, mouth or jaw |
Cerebral palsy |
Severe infections of the mouth or throat (oral thrush or ulcers) |
Dementia |
Postural problems (severe kyphosis) |
Huntingtons disease |
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Drug induced (psychotropic drugs) |
Diagnosis
Xray |
Dynamic swallowing study - OT |
Endoscopy |
Fiber-optic endoscopic evaluation of swallowing (FEES) |
Oesophageal muscle test |
Imaging scans |
Consequences
Choking |
Malnutrition |
Dehydration |
Weight loss |
Aspiration pneumonia |
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Signs and Symptoms
Signs and Symptoms |
Pain while swallowing |
Not being able to swallow |
Feeling as though food is stuck in the throat or chest or behind the breastbone |
Drooling |
Hoarseness |
Food coming back up |
Frequent heartburn |
Food and stomach acid backing up into the throat |
Weight loss |
Coughing or gagging when swallowing |
Nutrition Related Treatment
Texture modification of food and liquid. |
HPHE |
Avoiding hard, crunchy or stringy foods. |
monitoring the position of PT while they are eating |
smaller more frequent meals |
Safe swallowing (small bites, chew thoroughly) |
Encourage consistent fluid intake |
Promote oral hygiene |
Fortification of foods |
Between-meal snacks |
It is important to first determine the safest feeding route for your PT. For example, an oral feeding route may not be safe or adequate, so you may need to consider Enteral nutrition (EN), and a specific site (NG, PEG etc) or Parenteral nutrition (PN).
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