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[Dysphagia] Cricopharyngeal Diet
sorriso@adelphia.net wrote:
More on the subject: One of the posters/explainers further stated something to the effect that the passage of the bolus was equated to that of a substance moving through a funnel. Foods such as mashed/whipped potato, applesauce and pudding would be prohibited because they do not pass easily.
*** Are they serious? These are the very foods (with the possible exception of applesauce) that do pass most easily because of their weight and general cohesiveness. The research information on the topic of bolus consistency and UES function is extensive, dating from the early 1990's. It sounds as though they know nothing about the opening of the UES.
---- Irene Campbell-Taylor wrote:
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> We've come to learn that it stems from vitalstim education and the identification of and significance of cricopharyngeal dysfunction in dysphagia.
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> *** Well. well. Another example of the almost complete misunderstanding of swallowing physiology evidenced by the promoters of VitalStim. Many.many communications with them have led me to accept that I am banging my head against that proverbial brick wall. It is NOT a cricopharyngeal dysfunction (unless so demonstrated by manometry and in very specific cases) but failure of opening of the UES due to failure of anterior movement of the hyoid - the most common aspect of oropharyngeal dysphagia. The "diet" part refers to the multiple studies that have shown that the larger and heavier the bolus, the easier the passage through the UES - See, Kahrilas, Logemann, Dent, Cook, Ravich, Shaker etc. etc. (Which, as a by the way - has always called into question the inexplicable tendency to recommend tiny boluses for dysphagic patients. I'l never understand that one.)
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> Tiny crackers may be of a better consistency when mixed with saliva but not by much.
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> The "diet" part is very simple - larger, heavier boluses are easier to swallow than tiny, light ones as passage through the UES depends on the traction of the hyoid combined with the weight and velocity of the bolus - on which there is a plethora of research.
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> Dr I Campbell-Taylor
> Clinical Neuroscientist
> Exclusive Distributor:
> www.interactivetherapy.com
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Dr I Campbell-Taylor
Clinical Neuroscientist
Exclusive Distributor:
www.interactivetherapy.com
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