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Health Dictionary

Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Dysphagia secondary prevention

Introduction

Overview

Overview

Effective measures for the secondary prevention of dysphagia include chewing your food thoroughly and eating slowly.

Secondary Prevention

Secondary Prevention

  • Effective measures for the secondary prevention of dysphagia include:[1]
    • Chewing food thoroughly
    • Eating slowly
    • Swallowing therapy for stroke patients

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  • Other strategies include measures taken to prevent aspiration pneumnonia as swallowing disorders include:[2][3][4]

1. Prevention of aspiration during feeding

Following strategeis help in feeding and preventing aspiration:[5]

  • 30 minute rest before feeding
  • Make the person sit upright or elevate bed-rest to 90 degree angle.
  • ‘Chin-down’ or’ chin tuck’ maneuver which is a head and neck flexion which need to be avoided in cervical injured patients[6]
  • Avoid rushing to feed or providing appropriate time in between two feeds
  • Alternate solid and liquid boluses of diet
  • Consistency suited to personal needs to patient e.g. semisolid or pureed or mechanically altered
  • Minimizing sedatives to reduce the loss of cough reflex

2. Prevention of aspiration during tube feeding

  • Bedrest elevation to 30 degree at least for continuous feed
  • Noting the signs when the patient feels nauseous, abdominal fullness or pain
  • Check for the residual volume for gastric emptying time of the patient
  • Use motility drugs if residual volume is ≥ 250 ml[5]
  • Nasogastric tube feeding is similar to percutaneous gastric tube feeding [7]

3. Prevention of aspiration during oral care

  • Care of teeth and dentures to fit properly as misfit dentures are more prone to aspiration.
  • Evidence shows that oral cleaning and hygiene in nursing home residents reduce the risk of aspiration and improves the overall quality of life.[8]
References

References

  1. ↑ Philpott, Hamish; Garg, Mayur; Tomic, Dunya; Balasubramanian, Smrithya; Sweis, Rami (2017). “Dysphagia: Thinking outside the box”. World Journal of Gastroenterology. 23 (38): 6942–6951. doi:10.3748/wjg.v23.i38.6942. ISSN 1007-9327.
  2. ↑ Sue Eisenstadt E (2010). “Dysphagia and aspiration pneumonia in older adults”. J Am Acad Nurse Pract. 22 (1): 17–22. doi:10.1111/j.1745-7599.2009.00470.x. PMID 20074192.
  3. ↑ Langmore SE, Terpenning MS, Schork A, Chen Y, Murray JT, Lopatin D, Loesche WJ (1998). “Predictors of aspiration pneumonia: how important is dysphagia?”. Dysphagia. 13 (2): 69–81. doi:10.1007/PL00009559. PMID 9513300.
  4. ↑ Altman KW, Yu GP, Schaefer SD (2010). “Consequence of dysphagia in the hospitalized patient: impact on prognosis and hospital resources”. Arch. Otolaryngol. Head Neck Surg. 136 (8): 784–9. doi:10.1001/archoto.2010.129. PMID 20713754.
  5. ↑ 5.0 5.1 Bankhead, Robin; Boullata, Joseph; Brantley, Susan; Corkins, Mark; Guenter, Peggi; Krenitsky, Joseph; Lyman, Beth; Metheny, Norma A.; Mueller, Charles; Robbins, Sandra; Wessel, Jacqueline (2009). “A.S.P.E.N. Enteral Nutrition Practice Recommendations”. Journal of Parenteral and Enteral Nutrition. 33 (2): 122–167. doi:10.1177/0148607108330314. ISSN 0148-6071.
  6. ↑ Terré R, Mearin F (2012). “Effectiveness of chin-down posture to prevent tracheal aspiration in dysphagia secondary to acquired brain injury. A videofluoroscopy study”. Neurogastroenterol. Motil. 24 (5): 414–9, e206. doi:10.1111/j.1365-2982.2011.01869.x. PMID 22309385.
  7. ↑ Gomes CA, Andriolo RB, Bennett C, Lustosa SA, Matos D, Waisberg DR, Waisberg J (2015). “Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for adults with swallowing disturbances”. Cochrane Database Syst Rev (5): CD008096. doi:10.1002/14651858.CD008096.pub4. PMID 25997528.
  8. ↑ El-Solh AA (2011). “Association between pneumonia and oral care in nursing home residents”. Lung. 189 (3): 173–80. doi:10.1007/s00408-011-9297-0. PMID 21533635.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Amandeep Singh M.D.[2],Hamid Qazi, MD, BSc [3],Feham Tariq, MD [4]