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[Dysphagia] celiac disease
I suggest FEES. You can use regular food. No need for any additives
-----Original Message-----
From: dysphagia-bounces at dysphagia.com
[mailto:dysphagia-bounces at dysphagia.com]On Behalf Of Martha Carbone
Sent: Friday, June 01, 2007 10:01 PM
To: dysphagia at dysphagia.com
Subject: [Dysphagia] celiac disease
I have a 90-year-old woman with celiac disease on my caseload. I saw
her at the bedside two days ago. She had oral stage problems (excessive
chewing, pocketing of food after swallows). No overt s/s of aspiration
at the bedside, but she is likely silently aspirating secondary to
failure to thrive (extremely thin), RLL pneumonia. Because of her
severe gluten intolerance and other allergies, it was decided she
cannot have a VFSS. I had gathered gluten-free foods, but Varibar has
modified corn starch, which her daughter says is not good. Also, felt
she would not tolerate gastrograffin well.
She is currently on mechanical soft diet and thin liquids. I am
recommending that if they want to consider the safest, easiest diet
level, to try puree and nectar thickened liquids for her. Although corn
is not prohibited on the info I have read for this disease, the
daughter is adamant that mom is allergic to that and so she would not
tolerate the usual thickeners. I am wondering if anyone has any good
ideas on alternative thickeners to try. Per her daughter, mom can have
tapioca flour. I thought we could experiment using that. The only other
suggestion I had was to try blended "smoothie" type meals/drinks with
foods she can have that would be puree-to-nectar consistency. Any other
ideas/suggestions? Thanks for any thoughts.
Sincerely,
Martha Carbone, MS, CCC-SLP
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