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Esophageal dilatation
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Jennifer Billington, Niyi Ade-Ajayi
If a nasogastric tube has been left in place, this should be secured with occlusive, transparent dressing. Monitoring following dilatation should be carried out in a designated recovery area immediately following dilatation and should include regular measurements of pulse, heart rate, temperature, and blood pressure. If an adequate luminal diameter has been achieved, clear fluids may be permitted by mouth when the child is fully awake. If these are tolerated, then progression to milk is allowed followed by a soft diet if appropriate.
Postoperative Nutritional Management of the Bariatric-Surgery Patient
Published in Emmanuel C. Opara, Sam Dagogo-Jack, Nutrition and Diabetes, 2019
Patients are transitioned to a soft-foods diet around 10–14 days post-surgery at a medical assessment follow-up. These are soft, moist, chopped, ground, or mashed low-fiber foods and may include pureed fruit, canned fish and poultry, fruit and vegetable juices, white rice, noodles, and cottage cheese. Typically, patients tolerate this diet well and remain on it for 2–3 weeks. At the 1-month medical follow-up, patients are assessed for food tolerance/intolerance, hydration, and micronutrient status. If well-tolerated at this point, the soft diet can be progressed to a low-sugar, low-fat, high-protein, solid-food diet. Throughout the diet progression, patients should chew solid foods thoroughly and not drink beverages at the same time as eating. Interestingly, food intolerances remain fairly high, even more than 1 year post-surgery. In a sample of more than 100 post-surgery patients, 30% of the sample reported food intolerances, with the most frequent being red meat, rice, and sausage.46
Cricopharyngeal Dysphagia
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
It is the authors’ practice to recommend a soft diet for a week and then progress to a normal diet. The rationale behind this is that the discomfort that can be associated with swallowing can be minimized with a soft diet. Having been denied a good swallow for months, most patients need little encouragement to move on to a normal diet. It seems logical to treat patients with symptomatic gastric reflux with proton pump inhibitors although there is currently no evidence to suggest that this practice reduces the risk of recurrence.
Assessing adherence and exploring barriers to provision of prescribed texture modifications for dysphagia in a residential aged care facility in rural Australia
Published in International Journal of Speech-Language Pathology, 2022
C. Hill, R. P. Clapham, A. Buccheri, M. Field, A. Wong Shee, L. Alston
The results from the meal texture audits are not dissimilar from those found in previous research. Bennett (2015) conducted 41 mealtime observations for 14 residents from meal set-up to completion across two regional RACFs. These mealtime observations collected information on mealtime environment, location, seating, meal presentation, feeding assistance, resident-staff interaction and use of specific mealtime management strategies. That study identified that there were discrepancies between the prescribed texture-modified diets documented in resident’s files and the meals provided and what staff thought residents needed. Bennett (2015) noted that adherence to SLP recommendations was poor with residents receiving a diet texture inconsistent with their documentation in 51% of mealtime observations compared with an error rate of 64% in the current study. It was thought that this was due to many care staff being unaware of resident’s mealtime management recommendations and resident preferences being poorly documented in their files. Meal texture audits in this study identified highest error rates for soft diet and soft/cut up diets. This is similar to the study by Miles et al. (2020), which obtained data from 10 RACFs across New Zealand and found that 100% of RACFs offering soft & bite-sized diet options did not comply with the new International Dysphagia Diet Standardisation Initiative (IDDSI) criteria.
Client perspectives on living with dysphagia in the community
Published in International Journal of Speech-Language Pathology, 2021
Simone R. Howells, Petrea L. Cornwell, Elizabeth C. Ward, Pim Kuipers
Participants also noted a lack of awareness of dysphagia among medical professionals, including general practitioners, ENTs and maxillofacial surgeons: My ENT … he sort of doesn’t really get the whole swallowing thing, the importance of it, I don’t believe (P9). Participants shared anecdotes of seeking information and advice from their medical specialists about dysphagia and being disappointed with the outcome: When it [dysphagia] first happened to me, my first question to [maxillofacial surgeon] was “what is a soft diet?” … I didn’t have any idea. What he said to me was “oh, use your imagination with pasta.” That was all he said. He had no literature, no advice (P15). In some cases, this lack of understanding led to participants feeling their concerns were dismissed: I went “I’ve got this swallowing problem now and I’m so concerned about going to Japan. Can I go to Japan? What do you think?” and [neurologist] said “of course you can go to Japan, what’s the problem?!” (P13).
The effect of early oral feeding after esophagectomy on the incidence of anastomotic leakage: an updated review
Published in Postgraduate Medicine, 2020
Chu Zhang, Miao Zhang, Longbo Gong, Wenbin Wu
Pan et al. showed that patients who underwent elective MIE and initiated oral feeding 48 h after surgery had faster discovery and similar AL rate versus the control (7.5% vs 7.5%, p > 0.05) [16]. Shoar et al. reported that soft diet was started and tolerated significantly sooner in the EOF group than the late oral feeding group (5.8 days vs 9.5 days), whereas both groups indicated generally similar AL rate [18]. Sun et al. reported that EOF after MIE did not increase the risk of AL as compared with late oral feeding group (1 [3.6%] vs 2 [4.3%], p > 0.05); moreover, early postoperative gastric emptying for liquid food was significantly faster than that before surgery [17]. Additionally, Giacopuzzi et al. enrolled 22 patients who underwent esophagogastrectomy in EOF group (oral feeding since POD 1) and 17 patients in the late group (oral feeding since POD 5–6), and the two groups reported similar AL rate (1 [4.5%] vs 0) [19].