Nutrition in Clinical Practice

 

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Nutrition in Clinical Practice, Vol. 21, No. 6, 576-586 (2006)
DOI: 10.1177/0115426506021006576
© 2006 The American Society for Parenteral and Enteral Nutrition

Invited Review

Reinstituting Oral Feeding in Tube-Fed Adult Patients With Dysphagia

Michael A. Crary, PhD, FASHA* and Michael E. Groher, PhD, FASHA{dagger}

* Department of Communicative Disorders, College of Public Health and Health Professions, University of Florida Health Science Center, Gainesville, Florida; and the{dagger} Truesdail Center for Communicative Disorders, University of Redlands, Redlands California

Correspondence: Michael A. Crary, PhD, FASHA, Box 100174, Gainesville, FL 32610-0174. Electronic mail may be sent to mcrary{at}phhp.ufl.edu.

Feeding tubes are valuable assets in the rehabilitation of adult patients with dysphagia. Feeding tubes may be placed in response to perceived risks of airway compromise or insufficient nutrient intake. However, not all patients require long-term enteral feeding. With intensive dysphagia therapy, many patients will experience resolving deficits or improvement in swallowing ability. These patients require an appropriate strategy to transition from tube to oral feeding. This article reviews some of the basic characteristics of dysphagia and identifies specific swallowing difficulties in 2 groups of patients who often benefit from temporary enteral feeding: stroke survivors and patients treated for head and neck cancer. Specific suggestions are offered for clinical strategies to reinstitute oral feeding in these groups of tube-fed patients.


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