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Changes After a Brain Injury

​​Swallowing Changes after a Brain Injury

​​Trouble swallowing or moving food from the mouth to the stomach is called dysphagia.

Dysphagia can put the person at risk of choking or having food go into the lungs (aspiration) instead of the stomach. Besides being very uncomfortable, aspiration can cause pneumonia and can be life-threatening. Symptoms of dysphagia can include:

  • choking, gagging, coughing
  • trouble chewing
  • food spilling out of the mouth or coming through the nose
  • sneezing a lot while eating​
  • eyes water when eating
  • gurgling and/or having a strained voice after swallowing
  • feeling like food is stuck in the throat after swallowing
  • a congested chest, a lot of mucous
  • hurts to swallow

The brainstem and the frontal lobe coordinate swallowing. The brainstem sends messages to and from the mouth, tongue, and throat. The brain’s frontal lobes control the muscle action of the mouth, tongue, and throat. There are factors that can affect how a brain injury affects swallowing. These could be physical (trouble with muscles), related to the position of the body, or can be related to problems with thinking skills. Anyone of these areas can affect the ability to swallow properly and safely.

Swallowing can be affected by one or more of the following:

  • poor head or upper body control
  • less lip, tongue, and throat strength, range of motion, and coordination
  • trouble concentrating on eating
  • impulsive behaviour when eating (for example, takes bites that are too big)
  • can’t follow proper techniques when swallowing either because he forgets what he’s been told or that his brain has trouble remembering how to finish the movement for a safe swallow (apraxia)

A person who has trouble swallowing may need to get his nutrition through a nasogastric (NG) or gastrostomy tube (G tube). An NG tube is a feeding tube that goes up the nose and down to the stomach. A G-tube is a feeding tube that goes to the stomach.

Just because he has a feeding tube doesn’t always mean he can’t eat by mouth. The tube just makes sure that he gets the proper nutrition and fluids until he can eat and drink well enough on his own, if this is possible. How long that takes is different for everyone.

Exercises, treatments, and positioning may help improve how well a person can chew and swallow. A speech-language pathologist will teach him and his caregivers how to do these exercises and techniques. It’s important to only follow the exercises or treatments you are shown. As a caregiver, your support and help with the swallowing program are important. Many people do get back their ability to swallow after brain injury.

Please talk to your healthcare provider, such as a speech language pathologist or dietitian, for tips on how to help with swallowing problems and helping the person meet his nutritional needs.

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