Swallowing Disorders: When Eating and Drinking Become Difficult

Swallowing disorders, also known as dysphagia, can be a significant burden for both affected individuals and their family members. They occur in a variety of diseases across all age groups. They are especially common in neurological conditions such as strokes or Parkinson’s disease, in cases of structural changes in the throat area such as tumors or surgeries, or in the elderly with dementia. However, therapists such as speech therapists or dietitians can provide assistance and support.

Schluckbeschwerden beim Essen haben viele Ursachen und beeinflussen den Alltag in vielerlei Hinsicht

September 24, 2023

Eating & Drinking - Effortless Enjoyment?

A leisurely breakfast with friends, a delicious lunch with colleagues, or a fancy dinner with family. Eating and drinking are inseparably linked to well-being, enjoyment, and togetherness. Nothing connects us more than the pleasure of food.

However, what if meals become an insurmountable obstacle and even a health hazard? Medically, swallowing disorders are also referred to as dysphagia. They describe the inability to safely and efficiently transport food and beverages from the mouth to the stomach. Behind what seems like an effortless process, one that is automated and unconscious, there hides a multitude of difficulties: swallowing.

Following a variety of different diseases, various symptoms occur: from residues in the mouth or throat, to coughing, clearing one's throat, gagging, and choking on one's own saliva, or even repeated entry of food or liquid into the lungs. Sometimes this poses a life-threatening risk to the health of those affected. Difficulty with food intake, processing, or transportation is very common in acute neurological events such as strokes or head injuries.

But swallowing disorders also occur in diseases such as Parkinson's disease or amyotrophic lateral sclerosis (ALS). Tumors of the tongue or throat, as well as various forms of dementia, can make eating and drinking a challenge for both those affected and their families.

Speech therapists and dietitians - two important professions in the treatment of swallowing disorders.

Speech therapists are experts in the field of hearing, speech, voice, and swallowing. Together with other medical professionals, speech therapists work as a team in various clinical settings. They care for patients with swallowing disorders from the acute care setting in neurology, through advanced rehabilitation, to home or nursing home care. The rehabilitation of dysphagia can include exercise treatments, adjustments of consistencies and textures, or the use of various aids. Softer, less sticky, and properly minced foods or slowly flowing liquids are easier for patients to control and still allow for oral intake.

Dietitians ensure that the intake of essential nutrients is successful despite swallowing disorders. Among other things, dietitians ensure that the degree of grinding or pureeing for solid foods or thickening for liquids, as determined by speech therapists, is implemented correctly in the kitchen. Food and liquids should have exactly the quality necessary to enable safe swallowing. Dietitians also ensure that these modified foods provide sufficient nutrients, such as protein, as well as enough energy in the form of calories.

What can individuals with swallowing disorders and their family members do?

One way to improve swallowing disorders is the use of so-called texture-modified diets. These special dietary forms are prepared to be easier to swallow and reduce the risk of choking. There are different types of texture-modified diets, such as pureed or mashed foods that can be customized to individual needs. For example, fibrous meat pieces like poultry are pureed and then reshaped into an visually appealing form using a silicone mold.

However, an important task remains raising awareness about this issue. Swallowing disorders are often underestimated. It's crucial for family members and affected individuals to recognize early on that it's a serious problem and seek professional assistance. This includes not only adapting the diet but also assistance with handling utensils and drinking vessels, as well as the opportunity to enjoy eating and drinking calmly and without time pressure.

What does... mean?

Simon Sollereder, MScSpeech therapist, lecturer, therapy scientist
Simon Sollereder is a speech therapist by profession and has been working in the field of neurological early rehabilitation, neurology, and geriatrics in various settings for over 10 years.

From 2012 to 2015, he completed the Interdisciplinary Master's program in Cognitive Science at the University of Vienna and Zagreb. From 2015 to 2021, he was employed in the Speech Therapy program at the University of Applied Sciences Wiener Neustadt.

Since October 2021, he has been responsible for the speech therapy department at VASCage, a research center for vascular aging and stroke in Innsbruck, where his research focuses on neurogenic speech and swallowing disorders. He is involved in establishing an interdisciplinary research area related to clinical oral processing and is pursuing a Ph.D. at the Institute of Sport Science, Neurophysiology Group, at the University of Innsbruck.

He is a member of the DACH reference group of the IDDSI initiative, provides further training on various topics related to neurologopedia rehabilitation, and teaches at various universities of applied sciences in Austria.

Learn more about Simon Sollereder and his work at neuro-logopaedie.at .

Wolfgang Staubmann, BSc, MScDietitian, Lecturer
Wolfgang Staubmann, BSc MSc is a Dietitian & Lecturer (University of Applied Sciences) at Institut Diätologie at FH JOANNEUM.

His areas of focus in research and teaching include the following: working on ways to promote enjoyment and provide adequate nutrition for older people with altered sensory perceptions such as taste and smell; addressing questions related to healthy aging in the context of nutrition, integrated into the Health Perception Lab research laboratory.

He completed his dietitian training in 2012 and has been working at FH JOANNEUM since 2013.
In addition to his freelance consulting work, he completed a Master of Science in Health and Nutrition at University College Dublin in 2016. He teaches in various master's and continuing education programs in Styria.

In the course of his research activities, he has worked on projects such as SCOBES-AR, FABELHAFT, DAMIA – The elderly person eats differently, Nutrition in Old Age brochure, and MOOC Nutrition and Dementia.

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