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When You Can’t Swallow After Stroke: How Recover from Dysphagia

nurse helping a stroke patient that can't swallow after stroke

If you have difficulty swallowing after stroke, it’s likely that you have a condition known as dysphagia.

There are steps you can take to recover the ability to swallow, which you’re about to learn. But first, it’s important to understand what causes this condition, along with other complications that may arise. This article will explain it all.

Table of Contents

Why Can’t I Swallow After Stroke?

Dysphagia is a condition that impairs control over the muscles in the throat that are responsible for swallowing.

There are different types of dysphagia, but most stroke patients develop oropharyngeal dysphagia, which is caused by the neurological impact of stroke.

When a stroke damages the part of the brain that controls your throat muscles, the brain cannot send the correct signals to those muscles anymore. As a result, it can affect the ability to swallow.

The severity of dysphagia ranges. Some stroke patients can swallow with difficulty, but others can’t swallow at all. Survivors that struggle with swallowing after stroke require an alternative means of feeding, such as soft foods or, in severe cases, a feeding tube.

Fortunately, dysphagia often improves within the first two weeks after a stroke for most survivors. For individuals that do not experience quick recovery like this, rehabilitation can help maximize chances of long-term improvement.

Rehabilitation is important because serious complications can occur if dysphagia does not improve. Before we dig into the methods of rehabilitation, let’s discuss these complications.

Complications of Dysphagia After Stroke

Dysphagia is a condition that should be taken very seriously. Work closely with your medical team for support.

Patients with dysphagia are more prone to these complications:

  • Aspiration pneumonia. If you inhale food or liquid on accident, it can bring bacteria into the lungs and lead to aspiration pneumonia.
  • Choking. Difficulty with swallowing increases the risk of choking, which is a potentially life-threatening event. This is why close monitoring is essential if you have dysphagia, especially during mealtime.
  • Malnutrition. Dysphagia makes it more difficult to eat and drink, which can lead to malnutrition and other associated side effects such as unintentional weight loss, muscle atrophy (from lack of proper nutrition), and dehydration.

Now that you understand the causes and risks of dysphagia after stroke, let’s move onto recovery methods.

Recovery Steps for Regaining Swallowing After Stroke

The good news is that swallowing is a skill that many stroke patients can relearn through rehabilitation. Your healthcare team will be a great resource as you get started with recovery.

Here are some steps you can take to regain swallowing skills after stroke:

Step 1: Work with a Speech-Language Pathologist

A speech-language pathologist is someone who is highly trained in speech disorders – which includes swallowing problems like dysphagia.

While swallowing doesn’t involve talking, it is lumped into the category of speech because it involves your oral muscles. A speech-language pathologist (SLP) will be able to assess your unique conditions and tailor a unique rehabilitation program for you.

It’s highly encouraged to work with a speech-language pathologist because the complications of dysphagia are life-threatening! Protect your health and your life by working with a highly trained specialist.

Step 2: Practice Swallowing Exercises

speech language pathologist working with patient that can't swallow after stroke

©iStock.com/yacobchuk

It’s likely that your speech-language pathologist will practice swallowing exercises with you. The goal is to rewire the brain through neuroplasticity.

By practicing swallowing exercises repetitively, it stimulates neuroplasticity and encourages new neural networks to form in the brain. These neural pathways will “relink mind to muscle” so that you can regain control of the ability to swallow. Repetition and consistency are key as the brain requires lots of stimulation to rewire itself.

Ask your SLP to send you home with some swallowing exercises to practice on your own. That way you can get the repetition you need to keep improving.

Step 3: Try Some Aphasia Apps

Aphasia is a language disorder after stroke that is related to dysphagia only in that both conditions may require retraining of the oral motor muscles.

You can try using aphasia apps that include swallowing exercises, along with your homework from your speech-language pathologist. For example, the Lingraphica SmallTalk Oral Motor Exercises app contains lots of exercises to help improve swallowing after stroke.

Daily practice will help you see the best results, so you can practice these on your own in between sessions with your SLP.

Step 4: Consider Electrical Stimulation

Most patients are familiar with electrical stimulation for stroke rehabilitation — but in the context of improving leg or arm movement. However, electrical stimulation can help with all kinds of motor recovery, including dysphagia and other oral motor skills.

It works by applying gentle electrical impulses to your throat muscles. This helps send extra stimulation to the brain to encourage neuroplasticity.

Using electrical simulation alongside rehab exercises can help boost your results. Work closely with your therapists to discuss whether or not you’re a good candidate for electrical stimulation.

If you are, you will also need a therapist’s assistance in placing the electrodes because placing them in improper locations on your neck can be very dangerous. Do not attempt without assistance.

Tip: To get an electrical stimulation device for your throat, you often need a healthcare professional to order it for you.

Step 5: Eat Safely by Using Compensation Techniques

Although swallowing exercises and electrical stimulation are some of the most effective ways to regain swallowing after stroke, results will still take time. In the meantime, it’s important to protect your safety by minimizing your risk of choking or having silent aspirations.

Here are some tips to improve your safety with dysphagia:

  • Eat soft foods – they’re easier to chew
  • Drink thick liquids – it moves slower than thin liquids and reduces your chance of choking
  • Focus on sitting up straight – and definitely don’t lie down while eating!
  • Eat slowly – this greatly reduces your risk of choking
  • Avoid foods of varying consistencies like chunky soup – this is complicated and unsafe to eat with dysphagia

These compensation techniques can help protect your safety while you continue with your rehabilitation from stroke.

Please note, your speech-language pathologist will be the one to determine what texture of foods and liquids are safe for you at any given point in your recovery – they may recommend pureed foods and thickened liquids in the beginning of your recovery before hopefully progressing you beyond this if it’s safe to do so.

As you slowly regain your ability to swallow after stroke, make sure that someone is around as you begin to eat new foods.

Your safety is of the utmost importance!

How Long Does Dysphagia Last After a Stroke?

Studies show that most individuals with dysphagia recover within two weeks. However, every stroke is different and therefore every recovery will be different.

Sometimes dysphagia goes away on its own, a phenomenon called spontaneous recovery. Chances of spontaneous recovery are higher if your stroke was mild.

Generally speaking, more severe strokes will lead to more persistent dysphagia, according to European Neurology. When dysphagia is severe, often feeding tubes are required for the first month.

While your stroke recovery timeline will be highly unique to you, it’s understood that adherence to a consistent rehabilitation plan provides optimal chances for recovery.

Outlook for Stroke Patients with Dysphagia

Some patients may fully recover from dysphagia, especially if the stroke was mild. Other patients may require a feeding tube, which is more likely in the case of massive stroke.

Work closely with your speech-language pathologist and ask him/her for swallowing exercises that you can practice at home. This will help you get consistent, daily exercise so that you help the brain heal and rewire itself.

Most importantly, never lose hope. There are plenty of success stories of stroke patients who achieved a higher recovery than expected because they believe in themselves and put in the work. Good luck!

Featured image: ©iStock.com/monkeybusinessimages

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