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Recognizing Symptoms of Dysphagia After a Stroke

A caregiver assists a patient experiencing dysphagia following a stroke

Every year, more than 795,000 Americans have a stroke, or a sudden interruption in the brain’s blood supply.[i] Stroke is typically caused by a blockage of arteries leading to the brain or the rupture of an artery within the brain.[ii]

According to the National Institutes of Health, stroke is a leading cause of death and severe disability, including paralysis or problems controlling movement. [iii] One motor control issue that affects more than 50 percent of stroke patients is dysphagia, a disorder that can result from damage to the part of the brain that controls the muscles used for swallowing.[iv]

Because May is National Stroke Awareness Month, it is especially important to learn how to recognize symptoms of dysphagia that can occur after a stroke, which include[v]:

  • Coughing while eating or drinking
  • Food or drink going down the wrong way
  • Still having food or drink left in the mouth after swallowing
  • Not being able to chew properly
  • A croaky or gurgling voice
  • Drooling
  • Taking a long time to swallow or finish a meal

In addition to difficulty drinking, eating, swallowing, and controlling saliva, dysphagia can cause aspiration, which occurs when food or fluids enter the lungs.[vi] Aspiration typically triggers coughing; however, for stroke patients who cannot cough adequately, it can result in a life-threatening chest infection called aspiration pneumonia. In fact, stroke patients with dysphagia are seven times more likely to experience aspiration pneumonia.[vii]

Dehydration and malnutrition are also common in stroke patients with dysphagia. One study reported that 49 percent of stroke survivors admitted to a rehabilitation unit were malnourished, and that malnutrition was associated with dysphagia.[viii] Another study found that 58 percent of acute stroke survivors with dysphagia had signs of dehydration compared to 32 percent of those without dysphagia.[ix]

Because the majority of stroke survivors experience dysphagia, one of the first hurdles on the path to recovery is swallowing dysfunction. To begin addressing dysphagia in stroke patients, a speech-language pathologist (SLP), dietitian, or healthcare professional trained in treating swallowing disorders will conduct an examination, which could involve the following tests[x]:

  • Watching how well a patient chews and swallows different drinks
  • Taking an X-ray to see if food or drink is going into a patient’s lungs
  • Using a small camera to assess a patient’s swallow

Then, the swallowing specialist will design a treatment plan that might include:

  • A diet of thickened foods and liquids that are easier and safer for those with dysphagia to swallow. Following the recommendations from a healthcare professional, Thick-It® Food & Beverage Thickeners may allow patients to safely enjoy their favorite dishes and drinks without altering flavor, while Thick-It® Purées offer a variety of nutritious options for entrées, side dishes, and desserts.
  • Exercises to improve coordination of muscle movements in the mouth and throat.
  • Common precautions to help patients swallow safely, including sitting up straight while eating, taking small bites and sips, allowing plenty of time to chew and swallow, clearing all food from the mouth, and turning the head to one side to provide better airway protection.

Visit the American Stroke Association for more information about stroke, life after stroke, and articles about stroke survivors and their family caregivers.

[i] “May is National Stroke Awareness Month.” Society for Public Health Education.
[ii] “What is a Stroke?” The Internet Stroke Center.
[iii] “Post-Stroke Rehabilitation.” National Institutes of Health.
[iv] Atanelov L, Christian AB, González-Fernández M, Ottenstein L, “Dysphagia After a Stroke: an Overview.” Current Physical Medicine and Rehabilitation Reports.
[v] “Swallowing Problems.” Stroke Association.
[vi] “Difficulty Swallowing After Stroke (Dysphagia).” American Stroke Association.
[vii] S Singh, S Hamdy, “Dysphagia in stroke patients.” Postgraduate Medical Journal. June 2006.
[viii] Finestone HM, Greene-Finestone LS, Wilson ES, Teasell RW, “Malnutrition in stroke patients on the rehabilitation service and at follow-up: Prevalence and predictors.” Arch Phys Med Rehabil. April 1995.
[ix] Gordon C, Hewer RL, Wade DT, “Dysphagia in acute stroke.” British Medical Journal. August 1987.
[x] “Swallowing problems after a stroke fact sheet.” Stroke Foundation.

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