DYSPHAGIA: Difficulty in swallowing or  a serious swallowing disorder in known to be dysphagia. It may occur when the muscles of the mouth or esophagus fail to push foods to the back of the throat to initiate swallowing through the esophagus to the stomach. The causes of dysphagia are aging, AIDS patients, surgeries of head and neck, developmental disabilities, neurological disorders. Pain upon swallowing, fear of eating certain foods, weight loss, decline in food intake, choking , frequent throat clearing , a change in voice quality are some of the signs of dysphagia.

Dietary guidelines for  Dysphagia:

• Although some patients with dysphagia can swallow clear liquids , may need thicker liquids because they flow slowly allowing the patients to coordinate swallowing movements. Thin liquids can be thickened with commercial thickeners , baby rice cereals, Pureed fruits and vegetables can be given.
• Appropriate body positioning during meals minimize the risk of choking. Advise the patient to sit up right .
• Avoid sticky foods.
• Avoid talking while eating.
• Eat slowly.
• Calories and protein intake should be increased. Calories and proteins can be increased by fortifying foods .
• Foods should be avoided if they require chewing. Coarse textures should be avoided.
• Dysphagia diet is classified into four stages, this depends on viscosity and texture of the food.

 Foods to be eaten:

Stage 1: Pureed foods like fruits and vegetable purees, puddings, pureed meat and meat alternatives, mashed potatoes, Pureed gravies etc are the foods to be included under this stage 1. Sticky foods such as melted cheese or peanut butter are not allowed.

Stage 2: Diet includes minced foods. Examples of minced foods are smooth cooked cereals, pancakes, minced soft fruits and vegetables, scrambled eggs, soft moist casseroles, Minced meat and poultry, yogurt, minced potatoes.

Stage 3: Diet includes ground foods like fresh or canned foods without seeds, scrambled eggs, poached eggs, well cooked or canned vegetables, sliced cucumber with no skin or seeds, Noodles, ice cream, soft cookies, custard, creamed soups, ripe banana.

Stage 4:  All the above foods in 3 stages can be included and also finely chopped foods .chopped poultry and meat, toasted breads, tender cooked or soft raw vegetables, vegetable soup, creamed soups, flaked fish.

Foods to avoid:

Spicy foods, coarse hard foods, bacon, foods which are sticky like breads.