Dysphagia and Difficulty Swallowing

Dysphagia may occur in up to 65% of stroke patients according to Stroke Connection Magazine. It is a disorder characterized by difficulty swallowing food and drink. There may be weak mouth or cheek musculature making it difficult to move food around in the mouth. The swallowing response may also be impaired.

Swallowing difficulties can be extremely serious because food or drink may enter the lungs which can lead to aspiration pneumonia. Aspiration pneumonia can be fatal. According to varied sources, between 15-31% of all stroke-related deaths are due to aspiration pneumonia.

Symptoms of swallowing impairment can include food falling out of mouth, difficulty swallowing food down, coughing, choking while swallowing, food pocketed on one side of mouth without being swallowed, weight loss, and weak voice. Sometimes the patient will exhibit no outward symptoms. A test called the modified barium swallow can identify if a patient does indeed have swallowing problems. All stroke patients should be screened by a speech language pathologist for swallowing difficulties before being given food and drink.

Treatment for dysphagia may include swallowing therapy and dietary changes. Food and liquid consistencies can be changed to allow for easier swallowing. A physician may order a mechanical soft or pureed diet. Liquid can be thickened to pudding, honey, or nectar consistencies to help prevent aspiration of liquid into the lungs.

If swallowing is severely impaired, a stroke patient may need to have a temporary (or even permanent) feeding tube placed. There are two types of feeding tubes. A nasogastric tube is passed down the nose to the stomach and is often only used temporarily. A PEG tube (percutaneous epigastric tube) is surgically implanted into the stomach and can be used for longer amounts of time.

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