Managing Swallowing Problems in TBI Patients

Posted on January 22, 2022

The act of swallowing is taken for granted, but it is indeed a very complex process that begins when you first see food, triggering the salivary glands to start secreting saliva. Swallowing is an involuntary process during eating, a reflex activated when food touches the soft palate at the back of the mouth.

Swallowing involves multiple areas of the brain and over two dozen muscles. Damage to any of these can lead to dysphagia. Some older adults, too, have problems swallowing liquids or food. This may cause malnutrition, dehydration, or aspiration pneumonia. 

Since dysphagia is so dangerous, it's crucial to find a speech therapist to teach you exercises that improve your swallowing skills. Many people with dysphagia do not realize that they have problems swallowing. This can lead to serious health hazards. These are a few signs that your loved one might have dysphagia after their head injury:

  • Coughs after swallowing
  • Uncoordinated chewing
  • Drool
  • Weak voice
  • Grimaces while swallowing
  • Eats slowly
  • Complains about pain behind the sternum when eating
  • Pockets food in cheeks or gums
  • Wet, gurgling cough

As you practice those swallowing exercises, your brain relearns how to control your mouth muscles again, and your dysphagia may improve.

Many swallowing problems are caused by the absence of saliva or a dry mouth. There are numerous explanations why the salivary glands may not be making sufficient saliva:

  • Prescription Drugs: Medicines, including those for seasonal allergies, depression, urinary incontinence, and hypertension, can reduce the amount of saliva or alter its chemical composition so that it does not work correctly.
  • Disease: Parkinson’s Disease and Diabetes can cause dry mouth. Parkinson's can also weaken muscles involved in chewing and swallowing functions. 
  • Cancer Treatment: People undergoing radiation therapy for head and neck cancers can impede or even altogether stop saliva production. Chemotherapy can cause thick saliva, which gives a dry or sticky feeling in the mouth.
  • Trauma of the Salivary glands: Head or neck injury can damage nerves controlling the salivary glands.
  • Oral Health: As chewing is critical for regular food intake, the loss of teeth or poorly performing dentures can adversely affect the secretion of saliva.

Tips to Make Eating Easy

When a loved one is undergoing swallowing problems, there are simple diet modifications that can make eating easier for them:

Select moist foods. Softer, wet foods like oatmeal for breakfast, or soup for lunch, are easier to swallow. Canned or fresh fruits, such as peaches and oranges, have ample moisture and are good choices for any meal. Another meal option could be soft fish like tuna or egg salad.

Avoid foods that crumble. Crackers, for instance, might cause gagging. Avoid rough grains and dry particulates. As rice, other grains, and dry stuff such as corn, peas, and nuts may cause choking. Look for softer alternatives such as mashed rice and veggies.

Avoid foods high in spice and salt: These foods absorb more water and make the mouth drier. Spicy foods also irritate soft mouth tissues.

Steam raw vegetables thoroughly until they become soft. It will make them easier to eat while preserving essential nutrients. Flavor steamed vegetables with a simple pasta sauce.

Pick soft foods for dessert. Try fruit-flavored gelatin or a smoothie with a yogurt base. Cookies are OK if you soften them by dipping them in liquids such as milk or tea.

Puree or blend food for the elderly with parched mouths. Although you may want to expirement to notice if your loved one finds it easier to swallow consistency of blended or pureed food. Mincing or chopping foods may be enough for people with minor swallowing problems.

Candies or sugar-free gum between meals may help induce the glands to produce saliva and moisten the mouth.

Encourage fluids: Because swallowing issues can lead to a decreased ability to detect thirst, ensure your loved one drinks between six and eight cups of fluids daily. Dehydration can magnify the problem by reducing saliva secretions.