Swallowing Difficulties: What You Need to Know

By Bushra Davila, MBA, RD, LDN |
man with swallowing difficulties

Many of your members are cared for in their homes by family or other in-home caregivers.  Studies show that being a caregiver to someone with swallowing difficulties or dysphagia can be stressful. As a case manager, you are often the one they turn to for advice and support. The good news is there are ways to help! First, let’s take a look at the swallowing process:

Swallowing is a complex process that involves more than 50 pairs of muscles and many nerves. Food is moved from the mouth to the stomach in three stages. In the first stage, food is prepared for swallowing as it is moved around the mouth by the tongue. The second stage begins when the tongue pushes food or liquid to the back of the mouth. The third stage begins when food or liquid enters the esophagus. 

What causes swallowing problems?

Some people are born with swallowing problems, but it often develops due to a physical illness or medical condition. Difficulty swallowing, or dysphagia, can result from a stroke, Parkinson’s disease, multiple sclerosis, other neurological disorders, or pain upon consuming regular foods following oral surgery. People with cancers of the head, neck, and mouth or cancer treatment may also have trouble swallowing. 

What are the risks of swallowing difficulties?

In the worst cases, difficulty in swallowing can result in aspiration pneumonia. This occurs when food enters the lungs instead of the esophagus, causing bacterial infection, pneumonia, and death. If left untreated, dysphagia can lead to malnutrition and dehydration, unintentional weight loss, and decreased quality of life. This can affect all age groups, but it is most often seen in the elderly.

Benefits of a Pureed Diet

A pureed diet provides nutrition for individuals suffering from many different diseases and conditions but is designed specifically for patients who have difficult swallowing. Pureed foods have a smooth, cohesive, pudding-like consistency. A pureed consistency makes it easier to form a bolus, or ball of food, in the mouth before swallowing. The cohesive, smooth texture of pureed foods keeps the bolus together throughout the entire swallowing process to prevent food particles from entering the lungs. Sometimes when a person has dysphagia, it is necessary to thicken liquids to make swallowing them easier. 

People with dysphagia, or difficulty swallowing, usually follow this diet to prevent choking or silent aspiration. The time a person uses a pureed diet varies depending on the cause. People recovering from a stroke often use the diet for weeks to months, and those with worsening throat cancer or progressive degenerative disease may need to use it for the remainder of their lives.

People have different nutritional needs depending on various medical and dietary factors. As with any therapeutic diet plan, consult a physician and Registered Dietitian to individualize any diet to meet those needs.

What foods are allowed in a pureed diet?

Few individual foods are excluded from this diet because most foods can be processed to a pureed consistency. However, foods that require chewing are excluded.  

GA Foods’ Pureed Menu Plan consists of pureed meals for seniors and those with dysphagia, designed with all foods, including meats, vegetables, and fruits, to be the consistency of thickened pudding.  These meals follow Level 4 standards of The International Dysphagia Diet Standardisation Initiative (IDDSI). 

For more information, click here.