Dysphagia refers to a difficulty in swallowing or having pain during swallowing. The symptoms of dysphagia may range from mild pain to severe conditions. Some people may not be able to swallow food, and may have a problem even while consuming liquid foods or fruit juices. Any damage to the nerves and muscles associated with swallowing or other abnormalities in the swallowing process may lead to dysphagia. Dysphagia can occur in any age group with underlying medical conditions, congenital problems, and accidental damage of structure.
An individual having a problem in chewing or mastication process is recommended to have pureed foods. However, some patients may not require a liquid diet, and would be able to chew and swallow foods that are recommended for the next level. While speaking about dysphagia diet, usually the viscosity and texture of the foods are analyzed. The foods and liquids included in the diet may vary according to the severity of the symptoms. Hard cookies, candies, chewing gums, crispy, fried food, crackers, popcorn, nuts, seeds, hard-cooked eggs, dry bread, pizza, etc. should be avoided. Soft and moist food should be included in the diet.
All About Dysphagia Diet
The basic treatment for dysphagia is a modification in the diet plan and/or replacing with other foods. An indirect treatment for dysphagia involves certain exercises recommended for the improvement of the nerves and muscles associated with swallowing. Extensive studies have been done in order to formulate standard diets for the patients suffering from dysphagia. The studies are mainly based on the texture of solid foods and consistency of liquid diets. The scientific properties of foods are analyzed to develop less problematic foods for the people with swallowing disorders.
Liquid diets with a uniform viscosity allow the patient to swallow without aspiration of food residues. The viscosity also determines the peristalsis of the ingested food, as it moves down in the digestive tract. Depending upon the viscosity and texture of the food, the diet is primarily divided into four levels. With improvement in the condition, viscosity of the food can be gradually increased. The diet is so designed that a patient who could consume only liquids would be able to consume more solid foods over time. Various types of liquids and foods with a moist and soft texture are incorporated in the diet. To get the essential nutrients, a variety of foods should be present in the diet. Both hot and cold foods should be served. If the patient is not able to eat large meals, small and frequent meals can help maintain his energy levels. The doctor may prescribe liquid nutrition supplements, if required.
➺ Level I - Dysphagia diet starts with liquid or pureed food. Depending upon the severity of the condition, thin or thick liquids should be included in the diet. Diet under this level may consist of soft foods with similar consistency to pureed foods. Examples are pudding, thinned cooked cereals, pureed noodles, sauces, soufflés, fruit and vegetable juices, clear soups, milk, and gravies. The food should be homogenous, without any lumps, seeds, and chunks.
➺ Level II - The second level of dysphagia diet involves use of moist, soft, semisolid, canned, fresh, or cooked foods, that require some chewing ability. Fruits and vegetables that can be mashed with a fork can be incorporated in this diet. Dry foods should be excluded. Some examples are soft, well-cooked vegetables, tender and moist, ground or cubed meat, cooked cereals, plain yogurt, pureed vegetable soup, fresh bananas, and minced potatoes with cheese and gravy. The pieces of food in this stage should be very small, about the size of sesame seeds.
➺ Level III - This level encompasses soft-solid foods which require more chewing ability. For example, ground foods like ground fish and meat (tender and moistened), scrambled eggs, custard, ice cream, ground potatoes and noodles, creamed soups, and ripe bananas. The pieces of food in this stage should also be very small, but they can be about the size of a grain like rice. Bread should be well moistened.
➺ Level IV - Dysphagia diet under this category consists of finely chopped foods, some of which are chopped poultry and meat, chopped potatoes, cream cheese, vegetable soup, flaked fish, and omelets.
Based on the location of the problem, swallowing disorder is of two major types - oropharyngeal and esophageal. The former type refers to a difficulty in emptying food from the back of the mouth (oropharynx) to the esophagus; whereas in the latter case, there is a problem in passing the food particles down the esophageal tube. Dysphagia can result in certain complications such as tracheal aspiration and oral secretions. An individual having dysphagia may not be able to consume a balanced diet required for carrying out the vital activities of the body. In such a condition, he/she may suffer from weight loss and a weakened immune system. At times, food swallowed may get stuck in the windpipe that can lead to choking as well as bacterial infections.
Those who are likely to suffer from food particles going down the windpipe (trachea) are advised to consume only clear liquid diets. As the symptoms of dysphagia are reduced, the next diet plan should include soft and semisolid foods with a regular consistency. Very small amount of food should be swallowed at a time. One should sip liquids in between bites. In order to avoid dysphagia related complications, it is always advisable to maintain a particular food consistency as per the recommendations of the physician.
Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.