What To Expect: Post-Stroke Dietary Modifications At Home

Did you know that almost half of all stroke survivors experience dysphagia, a difficulty in swallowing? Dysphagia is one of the most common nutrition issues for post-stroke patients due to damage to the areas of the brain that control swallowing. This can lead to a range of swallowing difficulties, such as coughing or choking while eating or drinking, difficulty initiating a swallow, or food or liquid entering the lungs (aspiration), which can lead to lung infection.

Your speech and language therapist will evaluate your condition through an assessment to determine the nature and extent of your swallowing difficulties. Based on the assessment results, they will discuss with you and your family the most appropriate treatment or management plan for your specific needs. It involves: 

1. Modifying your diet with different food textures 

A texture-modified diet is a type of dietary modification that focuses on changing the texture of food to make it easier to swallow for people with dysphagia. In 2002, the Academy of Nutrition and Dietetics developed the National Dysphagia Diet (NDD), which provides guidelines for different levels of dysphagia diets: 

In addition to texture modification, the diet may also need to be modified in terms of taste, temperature, and consistency to ensure safe and enjoyable eating. 

The International Dysphagia Diet Standardisation Initiative (IDDSI) has also created a liquid description specifically for people with dysphagia. Drinks are ranked from 0 to 4 on this scale:

People with dysphagia often struggle with thin liquids like water, tea, coffee, and juice, as they can be hard to swallow and control the flow. Using flavorless gels or starches can easily transform any liquid into a consistency that's easier for you to manage. Your speech therapist may recommend you thicken your liquids before you drink them.

2. Acquiring the Right Techniques to Improve Swallowing

Your speech therapist may also teach you specific techniques to improve your swallowing, such as swallowing exercises, proper head and body positioning during meals, and strategies to avoid choking or aspiration.

3. Utilizing Aids to Facilitate Easier Eating or Drinking

Image source: Jackie Silver Nutrition

There are various aids available that can help make eating and drinking easier and safer for individuals with dysphagia. These may include special utensils, cups, or straws designed for people with swallowing difficulties. Your speech and language therapist can provide recommendations on the most suitable aids for you.

With the right support and guidance, regaining the ability to swallow after a stroke is possible.  Most patients with dysphagia do experience some improvement within just two weeks! However, it is important to remember that every stroke is unique and recovery can vary from person to person. So, if you or a loved one are experiencing dysphagia, talk to a healthcare professional and take the first step towards a full recovery.

This article is written by Jeff Fang (DOC2US) & Queenie Liu (DOC2US),
reviewed by Ashwini Nair, MB BCh BAO​ (DOC2US)​

REFERENCES: 

1. González-Fernández M, Ottenstein L, Atanelov L, et al. Dysphagia after Stroke: an Overview. Curr Phys Med Rehabil Rep. 2013 Sep;1(3):187-196. doi: 10.1007/s40141-013-0017-y. 
2. Shaker R, Geenen JE. Management of Dysphagia in stroke patients. Gastroenterol Hepatol (N Y). 2011 May;7(5):308-32.
3. Su M, Zheng G, Chen Y, Xie H, et al. Clinical applications of IDDSI framework for texture recommendation for dysphagia patients. J Texture Stud. 2018 Feb;49(1):2-10. doi: 10.1111/jtxs.12306. Epub 2017 Nov 13. 
4. McCullough G, Pelletier C, Steele C. National Dysphagia Diet: What to swallow? The ASHA Leader. 2003;8(20):16–27.

Written by

Jeff Fang (DOC2US) & Queenie Liu (DOC2US)