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Achalasia & Nutrition: A Detailed Dysphagia Diet Part One

Wednesday, July 15, 2009 @ 12:07 PM
posted by: admin

Source: Jackson Siegelbaum Gastroenterology

Nutrition facts

These diets are all nutritionally adequate. However, some patients may have difficulty taking enough fluid and food to get all the energy and nutrients they need. In this case, an adjustment to diet or treatment will be required.


Fluids are essential to maintain body functions. Usually 6 to 8 cups of liquid (48-64 oz) are needed daily. For some dysphagia patients, this may present problems because thin liquid can be more difficult to swallow. In this case, fluid can be thickened to make it easier to swallow. However, close monitoring by the dysphagia team is required for anyone drinking less than 4 cups of thickened fluid a day or anyone not progressing to thin liquids within 4 weeks.



The greater problem for some patients is eating enough calories. The whole process of eating simply becomes too difficult and too tiring. However, calorie and protein intake can be increased by fortifying the foods the patient does eat.

  • Fortify milk by adding 1 cup of dry powdered milk to one quart of liquid milk. Use this protein fortified milk when making hot cooked creamed soups, sauces, milkshakes, and puddings. Also add margarine, sugar, honey, jelly, or puréed baby food to increase calories.
  • Add strained baby fruit to juices, milkshakes, and cooked cereals.
  • Add 1 jar of strained baby meat to soup, such as strained chicken noodle soup. Also add strained baby meats to sauces and gravies, and mix with strained vegetables.
  • Add juice to prepared fruit, cereal, or milkshakes.

Special Considerations

The following are some general guidelines for safe swallowing. Remember that dysphagia patients have individual requirements, so all of these guidelines may not apply to every patient.

  • Maintain an upright position (as near 90 degrees as possible) whenever eating or drinking.
  • Take small bites — only 1/2 to 1 teaspoon at a time.
  • Eat slowly. It may also help to eat only one food at a time.
  • Avoid talking while eating.
  • When one side of the mouth is weak, place food into the stronger side of the mouth. At the end of the meal, check the inside of the cheek for any food that may have been pocketed.
  • Try turning the head down, tucking the chin to the chest, and bending the body forward when swallowing. This often provides greater swallowing ease and helps prevent food from entering the airway.
  • Do not mix solid foods and liquids in the same mouthful and do not "wash foods down" with liquids, unless you have been instructed to do so by the therapist.
  • Eat in a relaxed atmosphere, with no distractions.
  • Following each meal, sit in an upright position (90 degree angle) for 30 to 45 minutes

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