Post-stroke and dysphagia: Treatment plans to prevent difficulty swallowing after stroke

Dysphagia, or difficulty swallowing, is a post-stroke complication. If paralysis or loss of muscle control occurs on one side of the face, then talking and swallowing can become challenging. In some cases, patients may have difficulty speaking, understanding speech, putting speech together, or writing. A speech and language therapist can work with a patient in order to improve these abilities.

The process of swallowing consists of three phases: oral, pharyngeal, and esophageal.

Oral phase: Sucking, chewing, and moving food or liquid down to the throat.

Pharyngeal phase: Start of the swallowing reflex. Food is squeezed down the throat, which closes off the airways to prevent food or liquid from entering and thus prevent choking.

Esophageal phase: Relaxing and tightening the openings at the top of the esophagus and squeezing the food down the esophagus into the stomach.

Depending on which part of the brain is affected by stroke, any phase of swallowing may become impaired, increasing the risk of choking which can lead to death.

Symptoms and signs of swallowing problems after stroke

In dysphagia, a person can have problems in the pharyngeal phase and can experience the following signs and symptoms:

• Pain
• Excessive salivation
• Persistent coughing
• Heartburn
• Choking
• Nighttime coughing
• Feeling like something is stuck in your throat or chest
• Weight loss or dehydration
• Taking much longer to finish meals

Treatment plan to live with dysphagia

There are many different treatments for post-stroke dysphagia. Here are some of these approaches:

• Modifying the way you eat – tilting your head back, for example
• Using dilators to increase the size of the esophagus
• Making a small cut in the esophagus muscle fibers to widen the passageway for food to go through
• Inserting a tube directly into the stomach to bypass the swallowing process
• Using feeding tubes

Some patients get relief from an electrical simulation treatment.

• Aside from these treatment options, there are also tips to make eating after stroke easier.
• Take small bites and sips.
• Concentrate while eating – avoid talking or getting distracted.
• Avoid foods that can trigger coughing – try to stick with foods that are easy to consume.
• Ice down the throat prior to eating.

Prevention of dysphagia is complicated, as there are many different reasons why a patient may experiencing difficulty swallowing. Reducing your risk of stroke and dementia can help lower your risk of developing dysphagia. Detecting swallowing complications early on can help slow down progression of dysphagia and begin the necessary treatment right away.

Treatment of dysphagia and swallowing difficulties aims to target the underlying cause. As mentioned, some treatment options include swallowing therapy, dietary changes, feeding tubes, medications, and even surgery, depending on severity.

You will have to work with a team of doctors and specialists, such as a nutritionist and speech therapist, to get the best treatment for your diagnosis.