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Home-HD Symptoms

Swallowing Problems: Dysphagia
Don't Forget-Quick Reminders
Swallowing Problems:  Dysphagia
Signs & Symptom of Difficulties
Spitting up
Pooling food in mouth
Refusal of meals

Difficulty in swallowing frequently goes
undiagnosed and doctors need to be more alert to the condition, according to
a study released in Stockholm in 1999.
Trouble with swallowing can lead to malnutrition, dehydration, pneumonia,
anxiety, depression and isolation. Many patients are too embarrassed to talk about the problems or believe it's part of HD and that nothing can be done about it.
Difficulty in swallowing.
Dysphagia may be associated with esophageal obstruction as well as certain neurodegenerative or motor disorders involving the esophagus.
Results from impaired voluntary control
of the mouth and tongue, impaired respiratory control due to chorea, and impaired judgment, resulting in eating too rapidly, or taking overly large bites of food and gulps of liquid.
Dry mouth, which can be brought on by neuroleptics, anti-depressants, and anticholinergics, may worsen the problem.

People swallow an average 580 times a day.  In many cases, part of the food or liquid ends up going down the windpipe into the lungs which can cause pneumonia.
No medications are known to improve swallowing directly. Early referral to a speech-language pathologist will help identify swallowing difficulties, and periodic reassessment can identify changes in swallowing ability and suggest appropriate non-pharmacologic interventions such as a change in food consistency.
Devices such as enlarged grips or silver-ware and nonslip plates with raised edges to prevent spilling may prolong independent eating.
Recommendations for Mealtime
Calm atmosphere
No distractions
Comfortable position - upright
Eat slowly
Breathe before swallowing
Completely swallow before eating more
Take no more than 25 minutes per meal
Eat smaller more frequent meals
Products That May Help:
a plate guard in plastic or metal to help guide food onto your fork or spoon
non-slipmatting (Dycem, available at medical supply stores) to keep plates from sliding around; handles or wide bases to add to glasses or mugs for better stability
angled or bendable straws which permit drinking from a regular glass
Specially designed knives, forks, and spoons described here can be found at medical supply stores and some "gourmet" kitchen shops. They have been designed to help you overcome the problems of weak grip, lack of flexibility, limited range of motion, and poor coordination. A built-uphandle makes it easier to grasp eating utensils.
The simplest way to do this is to buy a length of Rubatoze at a medical supply store; this is foam-rubber tubing that comes with a variety of bore dimensions to fit a range of handle sizes. Or, you can use a child's bicycle handle grip.  We also used the large foam tubes found on hair curlers.
Several manufacturers make cutlery with square, round, oval, or built-up handles of varying lengths in light, standard, or heavy weights. Shop around to find which version is best for you. If you have trouble moving your wrist, finger, or arm, try a fork or spoon with a swivel or self-leveling mechanism.
Extension spoons and forks to assist with limited range or motion can be set at any angle. There are utensils designed to be attached to the palm rather than gripped by the fingers; the angle can be adjusted to compensate for lack of range of motion.