Dysphagia Diet

Dysphagia Diet - Mixture of foods, drinks, and actions to improve the chewing and swallowing of adequate amounts for full nutrition and hydration for patients suffering from dysphagia. Concerns of dysphagia included malnutrition, dehydration, and food and liquid getting in the lungs.

There are two types of dysphagia: esophageal and oronpharangeal. With esophagela dysphagia, material stops moving in the esophagus, the tube from the throat to the stomach. This is often caused by persistent stomach acid refluxing, causing inflammation, irritation and eventual narrowing of the esophagus. Oronpharyngeal dysphagia is where material stops moving in the mouth to the back of the throat; and is usually caused by nervous disorders like stroke, cerebral palsy, MS, Parkinsons, and Alzheimers, as well as cancer, trauma, and dental problems. Liquids are often a problem for patients, especially those with Oronpharyngeal dysphagia. In severe cases, saliva can even be hard to swallow.

A dysphagia is intended to reduce the risk of food going into your windpipe or lungs and to improve the ability to chew, move, and swallow food and liquids.

A dysphagia diet often distinguish liquids into a thickness scale:

1. Thin – Water, milk, juice, coffee, tea, sodas, Jell-O, ice cream, broth soups
2. Nectar – Syrup, Ensure, eggnog, tomato juice, cream soups
3. Honey - Honey
4. Pudding or Spoon thick – Pudding

Thickeners - Products to change the thickness with affecting the taste of liquids.

1. Starch based – powdered, different liquids and temperatures can change how much is necessary. Also can take time to thicken.
2. Gel based – Thickens liquids equally, without separating or over-thickening. Ready right away.

Dysphagia Diet is broken into three to five levels, from simple purees to modified regular food.

1. Level 1 – Pureed: Smooth Foods - Patients unable to safely swallow chewable foods or drink thin liquids
a. Thick, homogenous semiliquid foods with a pudding like texture, blended or pureed like mashed potatoes, pureed noodles, sauces, and gravies. Avoid
b. Medications must be crushed or liquid and mixed with pureed foodsc. No Water.
2. Level 2 – Minced: Moist, soft and small foods (<1/8”, sesame seed size) - Patients can swallow small amounts of easily chewable foods, but cannot safely swallow thin liquids.
a. Minced meats, cooked cereals, yogurt, and pureed vegetable soup. Avoid coarse textures, nuts, and raw fruits and vegetables.
b. Medications may need to be crushed or liquidc. No Water. Very thick liquids, with thickener allowed.
3. Level 3 – Diced: Soft and Bite sized (<1/4”, rice size) – Patient beginning to chew, but has problems chewing, moving and swallowing.
a. Ground meats, scrambled eggs, ice cream, creamed soups, ripe bananas. Avoid nuts, tough skins, corn, dry, crispy and stringy foods.
b. Medications may need to be crushed or liquid.
c. Liquids as tolerated.
4. Level 4 – Chopped (<1/2”, M&M size) – Persons chewing soft textures and swallows liquids safely.
a. Soft foods that do not require grinding. Finely chopped meats, cream cheese, vegetable soup, flaked fish, and omelets. Avoid nuts, raw, crisp and deep fried foods.
b. Medications as tolerated.
c. Liquids as tolerated.
5. Level 5 – Modified Regular –
a. Soft moist, regularly textured foods. Avoid nuts, dried fruit, coconut, hard or dry breads.
b. Advised to maintain food consistency at each level and meal. Also try to maintain a consistent bite and swallow size, and alternate bites with sips of liquids.

A dysphagia diet can also include exercises to improve and retrain the nerves and muscles of the mouth and throat.

Recommendations include:

Sit upright for eating and drinking
Place food well into mouth
Gently cough after each swallow