We often take actions like eating and drinking for granted. For people with conditions like Motor Neuron Disease, however, these simple acts can pose significant challenges. Weakened muscles in the mouth make it harder for food to be chewed and swallowed properly, which can be distressful and potentially harmful for the patient. Luckily, the best therapy for MND includes a variety of swallowing therapy options to address this. Let’s take a closer look.
What Is Dysphagia in Motor Neuron Disease (MND)?
Motor neuron diseases are a group of neurodegenerative disorders that selectively affect motor neurons – cells that control all the voluntary muscles of the body. These muscles are responsible for performing movements under one’s will and thus, motor neuron diseases impact one’s ability to perform voluntary movements.
Dysphagia refers to difficulty in swallowing, a common symptom in Motor Neuron Disease. It occurs when the muscles involved in swallowing weaken, making it hard to eat, drink, or even swallow saliva, which can lead to choking, weight loss, and malnutrition if not managed properly.
Early Signs of Swallowing Difficulties in MND
Swallowing activates both the voluntary and the involuntary muscles. Muscles in the lips, tongue, and jaw work to retain food and saliva in the mouth for proper chewing and preparation for swallowing, while the automatic reflex conveys the food down the throat to the stomach for digestion. In a patient with MND, nerve damage means that these muscles are unable to work properly, which can cause problems with chewing, swallowing, and saliva accumulation.
Difficulties with swallowing may be hard to notice at first. You may feel certain changes in the way you eat and swallow, such as
- A feeling of food being stuck in the throat
- A need to swallow more frequently to clear food or saliva
- Coughing or gagging while consuming food or beverages
- Drooling or leaking food from the mouth
- A choking feeling
It is important to identify these signs as early as possible and sign up for swallowing therapy for MND to avoid more complications later.
How Swallowing Therapy Helps MND Patients
If an MND patient is experiencing swallowing difficulties, their doctor will recommend them to a specialized healthcare team, including
- A speech therapist to teach proper swallowing techniques
- A dietitian to select foods that will allow for adequate nutrition and weight maintenance while accommodating swallowing needs
- An Occupational Therapist to teach the use of various aids to safer eating and drinking
Some of the aids that are commonly recommended as part of the best therapy for MND include:
- Head supports: These are useful in case neck weakness is causing the head to fall and inhibiting eating
- Valved straw: This reduces the difficulty of sucking liquids by keeping the liquid near the top of the straw
- Oral suction unit: This helps clear the mouth of accumulated food particles and saliva
- Percutaneous endoscopic gastrostomy (PEG): This is a special procedure for patients who find it excessively difficult to swallow – a tube is inserted straight into the stomach, whereby food and fluids can be passed
Techniques and Exercises to Improve Swallowing
To ensure that you get adequate nutrition while also enjoying your meals, here are some lifestyle tips to consider:
- Sit upright and face forward while eating
- Avoid distractions like talking or TV
- Eat in small mouthfuls, and take small sips of beverages
- Chew properly using the techniques taught
- Try out different types of food, including textures and temperatures, to assess the easiest for you to swallow
- Try blending foods into a smoothie texture for easier swallowing
- Avoid crumbly or excessively dry foods
- If you have trouble swallowing thin liquids, consider adding thickeners to them
- Take your therapist’s advice on high-calorie items that you can easily consume to meet your nutritional needs
- Continue to sit upright for about 20 minutes after a meal
- Take good care of your teeth so that you can chew and swallow better
- Get frequent check-ups to ensure that your airways are clear and that you are not at risk of a chest infection
Swallowing difficulties can inhibit eating habits and be a source of stress, but there are a variety of treatments available to tackle this. By gaining awareness on swallowing therapy for MND beforehand, you can work with your therapist to implement safe techniques and assistive devices so that you can still enjoy all the foods and beverages that you love.
Role of Speech and Language Therapists in MND
Speech and Language Therapists (SLTs) play a crucial role in managing communication and swallowing difficulties in individuals with Motor Neuron Disease. As MND progresses, speech may become slurred or difficult to understand, and swallowing can become challenging.
SLTs assess these issues early and provide strategies, exercises, and tools—such as speech aids or communication devices—to help patients maintain their ability to express themselves and eat safely for as long as possible.
Diet Modifications and Feeding Options in Advanced MND
In advanced stages of MND, swallowing can become significantly impaired, increasing the risk of aspiration and malnutrition. To address this, diet modifications—like pureed foods, thickened liquids, and smaller, more frequent meals—are introduced to ensure safer swallowing. When oral feeding is no longer sufficient, alternative feeding options such as percutaneous endoscopic gastrostomy (PEG) may be recommended to provide nutrition and hydration while reducing the risk of choking and aspiration.
How Plexus Supports MND Patients with Swallowing Challenges
At Plexus, a multidisciplinary team led by specialists provides holistic care for MND patients experiencing swallowing difficulties. Our approach includes early assessment by speech and language therapists, individualized diet planning by nutritionists, and the introduction of adaptive feeding techniques and tools. We aim to maintain safety, comfort, and nutrition through every stage of the disease, empowering patients and caregivers with the right guidance and support throughout the journey.
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FAQs
What causes swallowing problems in MND?
Swallowing problems in MND are caused by the progressive weakening of the muscles involved in chewing and swallowing, due to the degeneration of motor neurons that control voluntary muscle movements.
Can swallowing therapy improve quality of life in MND?
Yes, swallowing therapy can greatly improve quality of life by enhancing safety while eating, reducing the risk of aspiration, and helping patients maintain adequate nutrition and hydration for as long as possible.
When should feeding tubes be considered for MND patients?
Feeding tubes should be considered when swallowing becomes difficult or unsafe, leading to weight loss, dehydration, or frequent choking. Early discussion with the care team helps ensure a smoother transition when needed.
How does Plexus approach swallowing therapy for MND?
Plexus uses a multidisciplinary approach, combining speech and language therapy, nutritional guidance, and personalized care plans to manage swallowing challenges and support overall well-being throughout the progression of MND.
