What To Do About Swallowing Difficulties After A Stroke

Approximately 30% of stroke survivors experience some degree of dysphagia, or difficulty swallowing. In mild cases, patients may only experience coughing or choking while drinking water but are still able to consume soft foods like steamed buns, noodles, and bread. However, in more severe cases, patients may be unable to eat at all, requiring immediate intervention through swallowing rehabilitation therapy.

Understanding Swallowing Rehabilitation Therapy

One of the most commonly used treatments for post-stroke dysphagia is neuromuscular electrical stimulation (NMES). This therapy involves placing electrodes on the throat muscles responsible for swallowing. The electrical impulses help stimulate muscle contractions, which can improve muscle coordination and strengthen the swallowing reflex over time.

Feeding Training And Dietary Adjustments

Texture-Modified Diets For Swallowing Difficulties

In addition to electrical stimulation, patients can benefit from feeding training that involves modifying the texture of food and liquids. Foods are typically categorized into four types: jelly-like, porridge-like, thin liquid, and solid foods. Before introducing these foods, a comprehensive swallowing evaluation, including a videofluoroscopic swallowing study (VFSS), is conducted to assess the patient's ability to swallow safely.

Gradual Swallowing Practice

During the training process, patients begin with very small amounts of food or liquid—often starting with just 2 milliliters per swallow. As their swallowing ability improves, the volume is gradually increased to 3ml, then 5ml, and eventually up to 10ml. This progressive approach helps rebuild the muscles and neural pathways involved in swallowing, with the ultimate goal of achieving independent oral intake without assistance.