Difficulty Swallowing After a Stroke: Signs of Dysphagia

Following a stroke, patients may experience decreased range of movement, limited mobility, speech difficulties and dysphagia, or trouble swallowing. While dysphagia is often temporary for stroke patients, missing the signs can lead to life-threatening complications.

As such, it’s important that family members recognize the warning signs and work with a rehabilitation professional to develop an appropriate treatment plan.

Causes & Signs of Dysphagia

Nearly half of all stroke survivors show signs of oropharyngeal dysphagia, but most recover within seven days. However, 10 to 15 percent continue to have symptoms at least six months down the road.

Stroke weakens the muscles used for swallowing or causes them to become uncoordinated. Dysphagia patients may also have trouble eating, drinking and might not be able to keep saliva out of their airway.

The following signs indicate dysphagia when a patient tries to eat or drink:

• Coughing
• Throat clearing
• Liquid needed to wash down food
• Food sticks to the back of the throat
• Liquid comes back up through the nose or mouth
• Extra swallows to get food down
• Problems chewing
• Significant amount of time to complete a meal

How Dysphagia Affects Stroke Survivors

Beyond the immediate difficulties, aspiration – when a patient inhales food or drink – is a common complication of dysphagia. In these cases, food or drink swallowed ends up in the airway or lungs.

Individuals who just experienced a stroke might not be able to feel the obstruction or don’t have the muscle and lung strength to cough it out. As a result, “silent” aspiration occurs, leading to choking, long-term chest infection or pneumonia.

Patients are also at greater risk for weight loss, dehydration, malnutrition and an inability to take prescribed medications.

Treatment for Dysphagia

Rehabilitation helps a patient recover swallowing function and adapt to the limitations. Because dysphagia can have many complications, a typical treatment plan involves a team of specialists, including dieticians, nutritionists and speech pathologists.

A patient relearning to use all affected muscles needs to swallow safely, eat and drink the right foods. In the meantime, he or she may need to avoid thin liquids and tough foods.

With a Speech Pathologist

In the early stages of stroke rehabilitation, a speech pathologist evaluates a patient’s ability to swallow without choking. Depending on the patient’s abilities at the time, the following may be recommended:

• Exercises to strengthen and use the mouth in relation to range of motion and speed.
• Exercises to help improve respiratory functioning, especially coughing up food.
• Exercises to help strengthen the pharynx, which rests between the nose, mouth and esophagus.

A patient’s daily routine will also need to be readjusted. A speech pathologist may further recommend:

• Assistance whenever a patient eats and drinks.
• Drinking thicker liquids and eating softer solid foods.
• Certain motions and postures, such as sitting upright as you eat.
• Avoiding high-fiber foods, nuts, seeds and anything sticky or with low water content.
• Eating slowly and understanding limitations early.
• Certain nutritional supplements to round out the limited diet.
• Alternative feeding methods, such as a nasogastric tube that passes through your nose and into your stomach.

Work with the professionals at West Hartford Health and Rehabilitation Center to put together a short-term rehab plan for stroke recovery. To learn more, contact us today!