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Stroke Recovery: Coping With Eating Problems

Introduction

It is common to have trouble swallowing, also called dysphagia, after a stroke. You may not be able to feel food on one or both sides of your mouth. You may also have problems chewing or producing enough saliva. Or you may have other conditions that make eating difficult and increase your risk of choking or breathing in food or liquids (aspiration).

Other things that may interfere with normal eating include:

  • Problems seeing or judging where things are, especially on the side of your body affected by the stroke.
  • Problems recognizing familiar objects or remembering how to do everyday things.
  • Paralysis or weakness or trouble controlling movements (apraxia).
  • Problems with smell, taste, or the sense of feeling.
  • Depression, which can cause a loss of appetite and requires treatment.

If you have eating problems after a stroke, you will need a thorough evaluation by a speech therapist or another rehabilitation specialist. You may need special X-rays to see how you are swallowing. As you recover from a stroke, your rehabilitation team will monitor your progress. Swallowing and eating problems often improve over time, but some may last for the rest of your life. But there are many things you can do to make eating easier.

 

A stroke can damage parts of your brain that control muscles in your face and throat as well as muscles that help you chew and swallow.

When your swallowing muscles are weak or not working well, food and fluids may not move properly from your mouth down to your stomach. Food, fluid, or saliva can get into your airways or lungs and cause you to choke on or aspirate (breathe in) food or liquids. This can lead to an infection in your lungs (pneumonia), which can be very serious.

For these reasons, after your stroke you will need tests to see how well you are eating and swallowing. A speech-language pathologist or another specialist may do the tests when you are in the hospital. If you have swallowing problems, you will need to be careful when you are eating.

Test Your Knowledge

When swallowing muscles are weak or not working well, food and fluids may not move properly from the mouth down to the stomach. This can cause pneumonia.

  • True
    This answer is correct.

    When swallowing muscles are weak or not working well, food, fluid, or saliva can get into the airways or lungs and cause choking or aspiration (breathing in food or liquids). This can lead to pneumonia.

  • False
    This answer is incorrect.

    When swallowing muscles are weak or not working well, food, fluid, or saliva can get into the airways or lungs and cause choking or aspiration (breathing in food or liquids). This can lead to pneumonia.

  •  

Continue to Why?

 

People who have trouble eating and swallowing after a stroke are at risk for:

  • Not eating enough, which can lead to malnutrition. Lack of proper nutrition can delay recovery and cause other problems, such as losing too much weight.
  • Not drinking enough liquids. Being dehydrated over a long period of time can cause health problems, and severe dehydration can be life-threatening.
  • Breathing in food or liquids (aspiration). This can lead to infection of the lungs. Although many people who have had a stroke cough or choke when they breathe something into their airway, some people may not know that they have breathed something into their lungs.

Test Your Knowledge

A person who breathes food or liquid into the airway or lungs always coughs or chokes.

  • True
    This answer is incorrect.

    People who have had a stroke may not know that they have breathed in (aspirated) food or liquid.

  • False
    This answer is correct.

    People who have had a stroke may not know that they have breathed in (aspirated) food or liquid.

  •  

Continue to How?

 

Work with your speech therapist or other health professional to find out what help you need. The following are some tips for eating and swallowing safely:

During meals and snacks, remember to:

  • Eat when you are rested and at your best. If you become tired with larger meals, eat small, frequent meals.
  • Sit as upright as possible. In some cases, your swallowing team will recommend a different position.
  • Avoid distractions (such as watching TV) and talking.
  • Allow enough time for meals so that you are not rushed.
  • Take small bites and sips. Finish each bite or sip before taking the next.
  • Stay upright for at least 30 minutes after meals and snacks.

If your therapist prescribes different food or fluid consistencies, remember to:

  • Eat and drink the food and fluid consistencies recommended by your rehab team.
  • Follow the thickening instructions given by your rehab team (if appropriate).
  • Take your medicines one at a time with the food or fluid consistency recommended by your rehab team. Your rehab team may also recommend that you crush the pills. Check with your pharmacist before crushing or breaking medicines.

For mouth care after a stroke:

  • Remember to brush your teeth, tongue, gums, and cheeks twice a day, even if you wear dentures. Regular mouth care helps control the growth of bacteria in your mouth. This can lower your risk for a lung infection (pneumonia).

Test Your Knowledge

You should never thicken food or fluids.

  • True
    This answer is incorrect.

    You will need to follow the thickening instructions given by your rehab team. Some people will need to thicken fluids or food to prevent choking or aspiration.

  • False
    This answer is correct.

    You will need to follow the thickening instructions given by your rehab team. Some people will need to thicken fluid or foods to prevent choking or aspiration.

  •  

It's best to eat when you are rested and not distracted by TV or guests.

  • True
    This answer is correct.

    Eat when you are rested and at your best. Avoid distractions (such as watching TV and talking) while you are eating and drinking.

  • False
    This answer is incorrect.

    Eat when you are rested and at your best. Avoid distractions (such as watching TV and talking) while you are eating and drinking.

  •  

Continue to Where?

 

Talk to your speech therapist, occupational therapist, nurse, or doctor to learn more about managing your eating problems.

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Credits

By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer Richard D. Zorowitz, MD - Physical Medicine and Rehabilitation
Last Revised June 26, 2013

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