This is abnormal or difficulty swallowing in a safe and efficient way. Dysphagia is a symptom and could be a side effect of several pathologies. It may result from structural abnormalities (structural dysphagia, because of tumours (head, neck and oesophageal tumours) or because of an impaired swallowing function (neurogenic dysphagia) due to neurological pathologies (Alzheimer’s disease, amyotrophic lateral sclerosis, stroke, Parkinson’s disease, etc.). Impaired swallowing may appear with foods of different textures. Difficulty swallowing liquids usually suggests a neurological cause and difficulty swallowing solid food often indicates a structural problem. It is very important to correctly evaluate the symptom because not swallowing safely can have consequences such as respiratory infections because of inhaling food, or in some cases even dehydration and malnutrition.

There are several tests to evaluate the dysphagia. The volume and viscosity test (V-VST) is the most widely used; and trials such as videofluroscopy to evaluate which phase of swallowing has a problem. Once the dysphagia is confirmed, it has to be evaluated which texture is suitable for the patient to achieve safe swallowing.

During an initial stage administration of thickeners such as Bi1 may be sufficient to increase the consistency of liquid foods and avoid intake episodes.

If the dysphagia is severe, it can hinder intake and prevent the patient from achieving correct nutrition. During neurological pathologies this symptom gets worse and disease prognosis also deteriorates with malnutrition. In such cases, we have to consider the possibility of using nutritional supplements, according to the underlying pathology: normoprotein-high calorie (Bi1 plus) or high-calorie and high-protein (Bi1 HP/HC) or normocaloric and normoprotein with fibre (Bi1 fibre) because neurological pathologies often go hand in hand with constipation. Thickener can be added to these supplements to ensure a texture that facilitates safer and more effective swallowing.

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