Frequency of swallowing disorders in patients with ischemic stroke.

credit:doi:10.3390/nu16081196.

Dysphagia, a condition characterized by difficulty in swallowing, encompasses various manifestations regarding the ingestion, fragmentation, and transport of food from the oral cavity to the stomach. Definitions of dysphagia may vary across medical literature, with the European Society for Swallowing Disorders acknowledging both oropharyngeal and esophageal swallowing difficulties, among which oropharyngeal dysphagia predominates over esophageal dysphagia. A recent retrospective study on dysphagia in ischemic stroke patients sheds light on post-stroke dysphagia scenarios.

Post-stroke dysphagia predominantly presents as oropharyngeal dysphagia. However, within stroke symptomatology, dysphagia has often been underestimated. Yet, dysphagia predisposes individuals to respiratory tract infections, thereby escalating the risk of mortality. Thus, early identification of dysphagia in stroke patients is paramount for adjusting dietary regimens, selecting appropriate speech therapy exercises to ameliorate swallowing function, and mitigating pulmonary complications.

This retrospective study encompassed 170 stroke patients, among whom 112 were diagnosed with oropharyngeal dysphagia via endoscopic examination. The objective of dysphagia management, as posited by the authors, is to minimize the frequency of aspiration and increase oral feeding instances, thereby enhancing the quality of life for stroke patients. Current feeding modalities for stroke patients encompass maintaining the existing dietary regimen, dietary modifications, nasogastric tube feeding, and percutaneous endoscopic gastrostomy (PEG) placement.

The study elucidates that the adjustment of feeding modalities hinges upon the severity of dysphagia. While no disparity in mortality rates was observed between nasogastric tubes and PEG, the latter exhibits superior efficacy and safety, bearing significant implications for improving the quality of life for stroke patients. Notably, 75% of pneumonia cases among the studied cohort utilized PEG tubes, underscoring the pivotal role of PEG in preventing or exacerbating aspiration pneumonia in stroke patients.

Consequently, the article advocates for the provision of dedicated speech therapists within neurology departments, facilitating comprehensive swallowing assessments and fiberoptic endoscopic evaluations, thereby furnishing tailored dietary recommendations and swallowing exercises based on diagnostic findings. Moreover, the article delves into silent aspiration, depression, and related concerns, underscoring dysphagia as a significant diagnostic and patient care issue necessitating collaborative efforts among various healthcare providers, including neurologists, specialist nurses, physiotherapists, speech therapists, and psychologists.

More information：Maciejewska O, Kępczyńska K, Polit M, Domitrz I. Dysphagia in Ischaemic Stroke Patients: One Centre Retrospective Study. Nutrients. 2024 Apr 17;16(8):1196. doi: 10.3390/nu16081196. PMID: 38674886; PMCID: PMC11054977.