Eating and drinking after a stroke

Many people who have had a stroke can find it difficult at first to swallow normally – they may cough or choke in the early days of their recovery. Difficulty with swallowing (or dysphagia) happens after a stroke because the brain doesn’t activate muscle reflexes at the back of the throat quickly enough, so that food or liquids pass down the throat into the larynx and/or lungs – in other words they can ‘go down the wrong way’. It can be frightening when swallowing doesn’t work automatically, but many things can be done to help, and most people recover their swallow in a couple of weeks.

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Tests for swallowing

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Usually, people who have had a stroke are watched carefully as they swallow for the first time and will only be given a small sip of water to see what happens. Tests are usually carried out by a Speech and Language TherapiY

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Speech and Language Therapists will also give advice about how and what to swallow such as softened food and thickened drinks.

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If problems with swallowing continue, the person may be asked swallow a small amount of fluid containing barium – a substance that shows up under x-ray – which helps medical professionals find out exactly what is happening as the liquid goes down the throat.

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The Stroke Association has a useful leaflet on ‘Swallowing problems after stroke’ and so do Chest, Heart and Stroke Scotland.nnChanges to dietnnIt is important for people recovering from a stroke to be well nourished so those who find it hard to swallow will be advised by dietitians and may be given pureed foods and specially thickened drinks.

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nMany people we spoke to said they disliked pureed food – they didn’t like either the look or the texture of the food once it was ‘mushed up’. One man described how he lost weight in hospital because he found he couldn’t manage to eat pureed food.

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When someone has a severe swallowing problem it may be necessary to feed him/her through a tube that goes through the nose, down the throat and into the stomach. One man said the naso-gastric tube made him sick. The medical staff stopped using it once he was able to swallow pureed foods. Another way of getting food into someone’s system is through a gastrostomy tube (usually called a PEG tube) which is inserted directly into the stomach.

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Other kinds of eating difficulties following strokennOther people found they had problems getting food from the plate into their mouths because they couldn’t use one or both of their arms/hands well enough to hold a knife and fork. Several people told us that not being able to use cutlery properly and cut up their own food put them off going out for meals. Adapted cutlery can often overcome these problems.

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Others talked about finding it difficult to sit up straight enough to eat when they were in hospital. Numbness on one side of the mouth meant that people had to be careful when they were chewing and also when they were putting food into their mouths.

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Changes in taste

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nLoss of taste, or dysgeusia, may occur following a stroke, but is far less common than other side effects of stroke. One woman experienced a change in taste following her stroke and was no longer able to eat certain foods.

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