Prevention is the best option

Dietary guidelines for people who have suffered a stroke

Individuals who have had a stroke may experience issues such as difficulty swallowing (dysphagia), decreased sensitivity to heat, changes to their sense of smell or taste, and/or difficulty handling cutlery. In these cases, a change of diet is in order, along with the introduction of techniques that facilitate eating and help avoid episodes of choking.

Description

Changes to the patient's diet

  • A varied diet rich in proteins and fibre and low in salt is recommended, restricting fats and fried foods. Following a Mediterranean diet, which features fresh and seasonal products, is advisable.
  • Patients who experience changes in their sense of smell or taste, or decreased hunger, should be monitored to avoid excess weight loss that can be caused by malnutrition.
  • If they have a decreased sensitivity to heat and can not tell if the food is too hot, the temperature of the foods given should be controlled to avoid burns.

Patients with dysphagia

  • The food should not have lumps and should not be too hot. To encourage swallowing, cold and hot (but not hot enough to burn) foods can be alternated.
  • The patient should have their back straight and head upright. Sometimes, however, their chin can be lowered to facilitate swallowing.
  • To make drinking easier, you can use small glasses, avoiding straws and small bottles.
  • Food should be given frequently but in small quantities, on the patient's good side. To ensure there is no food left in their mouth, you can wait until they swallow once or twice.
  • Avoid distractions while eating.
  • If the patient tends to cough or choke, chemical thickeners (bought at the pharmacy) or natural thickeners (potato, flour, or bread, among others) can be used.

Using a feeding tube

  • The food should be finely mashed and mixed with water.
  • The patient should be in a seated or semi-seated position while being fed.
  • Even when feeding is done through a tube, correct oral hygiene should be practised.
  • When the feeding is interrupted, it is important to put a little water into the tube to avoid blockages and to later keep the cover of the feeding tube closed. If an obstruction occurs, you can try to unblock the tube with oil or a cola soft drink. If this does not work, you should go to the health centre.
  • If it is a nasogastric tube, the nasal cavities should be cleaned daily and the place in the nose where the tube is inserted should be rotated to avoid the formation of ulcers.
  • If the patient has a gastrostomy tube, the skin around the tube, the tube itself, and the connectors should be cleaned daily with soap and water. The tape securing the tube must also be changed daily, covering the area with gauze affixed with surgical tape.

If the patient has mobility problems

  • Use cups with two handles.
  • Serve the food in bowls or soup plates.
  • The handles of the cutlery should be thick.
  • Non-slip tablecloths should be used.

If the patient has problems defecating

In the case of constipation:

  • Maintain a diet rich in fibre and encourage mobility whenever possible.
  • Establish a set time to defecate, preferably on the toilet, avoiding faecal collection systems or nappies.
  • Laxatives or enemas should only be used if a doctor prescribes them.

In the case of diarrhoea:

  • Provide an astringent diet and keep the patient hydrated.
  • If it continues for more than two days, consult a physician.

If urinary incontinence is an issue 

  • Take note of the quantity and frequency of urine (incontinence, urine infection and retention).
  • The patient must drink one and a half litres of liquid a day and reduce liquid intake from late afternoon onwards.
  • If the patient has light bladder leakage, offer them the chance to go to the bathroom frequently until they have better control of their sphincter.
  • In the case of incontinence, nappies or a urine collector can be used, keeping the skin clean and dry.

 

 

Author:

Estela Sanjuan

Research nurse. Coordinator of research and clinical trials at the Stroke Research Group at the Vall d'Hebron Research Institute.

  
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