[Dysphagia] diet modification question

[swlslp at yahoo.com (Sandi Lancaster)]

Just wanted to send a thank hyou to everyone who gave
good insight into my diet modification question...as
always, the responses I got, on the list and off-list,
were very helpful.  Thanks to everyone!

-Sandi


--- Vicky Wood <vwood@doh.health.nsw.gov.au> wrote:
> 
> Hi 
> I tend to partially disagree. In regards to
> mastication of bolus
> patients may have the ability to prepare the bolus
> adequately due to a
> normal oral phase. However, as a person becomes
> hungry or is consuming
> food that her or she enjoys, protein receptors from
> the oral cavity are
> sent to the hypothalamus to accelerate our intake.(
> Note: Once this
> bolus reaches our stomach and duodenum it triggers
> these receptors that
> signal the hypothalamus to induce satiety. This is
> how we don't overeat.
> Prader-Willi Syndrome has a break down in this area)
>  This is called the
> appetizer effect.
> We don't see people increase rate of food to the
> mouth so how do we
> accelerate our intake? We accomplish this by
> decreasing the oral prep
> stage. Basically masticating the bolus less. 
> Therefore despite the ability with the oral phase,
> the  phenomenon
> "appetizer effect" may override this resulting in
> difficulty with
> pharyngeal and esophageal motility etc.
> Also, with working on a geriatric ward, I  often see
> very impulsive
> patients that skip the oral prep stage all together
> however present in a
> artificial, controlled environment like MBS
> assessment quite well.
> Im sure there are plenty of other examples like
> this.
> Imperative to look at the patient in a holistic way
> to determine if a
> modified diet is suitable not just at the oral phase
> post MBS
> assessment.
> 
> 
> Vicky Wood
> Speech Pathologist
> 
> 
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> expressed in this message are those of the
> individual sender,
> and are not necessarily the views of NSW Health or
> Cancer Institute
> of NSW.

Sandi Lancaster, M.A. CCC-SLP
Speech-Language Pathologist

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