Maintaining adequate eating habits as a laryngectomee
- Increase Fluid Intake: Since laryngectomees may have difficulty swallowing, it’s important to consume plenty of fluids to prevent dehydration. Sipping water throughout the day, consuming soups, broths, and hydrating fruits like watermelon can help meet fluid needs.
- Frequent, Small Meals: Due to challenges with swallowing and reduced stomach capacity, laryngectomees may find it easier to consume several small meals throughout the day rather than three large ones. This helps prevent discomfort and ensures adequate nutrient intake.
- Choose Nutrient-Dense Foods: Opt for foods that provide essential nutrients without the need for excessive fluid intake. Focus on incorporating lean proteins such as chicken, fish, eggs, and legumes, as well as fruits, vegetables, whole grains, and healthy fats into your diet.
- Limit Liquid Intake During Meals: Consuming large amounts of liquid during meals can fill up the stomach quickly, leaving less space for nutrient-rich foods. Try to limit fluid intake during meals and instead drink fluids between meals to stay hydrated.
- Address Swallowing Difficulties: Work with a speech therapist or swallowing specialist to learn techniques to improve swallowing function. This can help reduce the need for excessive fluid intake while eating and improve overall nutrition.
- Manage Fluid Intake Before Bedtime: Consuming fewer liquids before bedtime can help minimize disruptions to sleep patterns caused by frequent urination. Aim to drink fluids earlier in the day and limit intake close to bedtime.
- Consider Individual Health Conditions: If you have underlying health conditions such as congestive heart failure, consult with your healthcare provider for personalized dietary recommendations. Managing fluid intake is particularly important for individuals with heart issues to prevent exacerbation of symptoms.
- Monitor Symptoms: Pay attention to signs of dehydration, such as dry mouth, dark urine, and fatigue, and adjust fluid intake accordingly. It’s essential to stay well-hydrated to support overall health and recovery.
- Seek Professional Guidance: Work closely with a registered dietitian or nutritionist who has experience working with laryngectomees to develop a personalized nutrition plan that meets your specific needs and preferences.
To enhance nutrition and manage potential issues like food reflux for laryngectomees, the following strategies can be helpful:
- Balanced Fluid Intake: Consuming sufficient but not excessive amounts of liquids is important. It’s essential to stay hydrated without overloading the stomach, which can exacerbate reflux. Drinking fluids between meals rather than during meals can help achieve this balance.
- Fluid Timing: Drinking less liquid in the evening can help minimize nighttime reflux symptoms. Limiting fluid intake closer to bedtime can reduce the likelihood of stomach contents refluxing into the esophagus while lying down.
- Healthy Food Choices: Opting for nutrient-dense, “healthy” foods can support overall nutrition and well-being. This includes incorporating a variety of fruits, vegetables, lean proteins, whole grains, and healthy fats into the diet.
- Low Carbohydrate, High Protein Diet: A low-carb, high-protein diet plan can be beneficial for laryngectomees, as it may reduce the risk of yeast colonization and support optimal nutrition. However, it’s important to ensure that the diet is balanced and includes essential vitamins and minerals from a variety of food sources.
- Consultation with a Dietitian: Seeking support from a registered dietitian or nutritionist can provide personalized guidance and meal plans tailored to individual needs and preferences. A dietitian can help ensure that nutritional requirements are met while managing specific dietary concerns, such as reflux.
- Medication Management: Taking medications, such as antacids or proton pump inhibitors (PPIs), as prescribed by a healthcare provider can help reduce stomach acidity and alleviate symptoms of reflux. It’s important to follow the prescribed regimen and discuss any concerns or side effects with a doctor.
- Posture and Eating Habits: Avoiding lying down or bending forward immediately after eating can help prevent reflux by allowing gravity to aid in digestion. Eating smaller, more frequent meals rather than large meals can also help minimize reflux symptoms.
By implementing these strategies and working closely with healthcare professionals, laryngectomees can optimize their nutrition and manage issues like food reflux to support overall health and well-being before and after a laryngectomy operation.
The signs and treatment of stomach acid reflux, also known as gastroesophageal reflux disease (GERD), are as follows:
Signs of Acid Reflux (GERD):
- Heartburn: Burning sensation in the chest, often after eating or lying down.
- Acid Taste in the Throat: A sour or acidic taste in the back of the throat.
- Chest Discomfort: Pain or discomfort in the chest area.
- Difficulty Swallowing: Sensation of food sticking in the throat or difficulty swallowing.
- Raspy Voice or Sore Throat: Hoarseness, sore throat, or irritation in the throat.
- Cough: Persistent cough, especially when lying down or at night.
Treatment and Management:
- Weight Loss: For individuals who are overweight or obese, losing weight can reduce pressure on the stomach and alleviate symptoms of GERD.
- Stress Management: Practicing relaxation techniques such as deep breathing, meditation, or yoga can help reduce stress levels, which may exacerbate reflux symptoms.
- Dietary Modifications: Avoiding foods and beverages that can trigger or worsen reflux, such as coffee, chocolate, alcohol, peppermint, and fatty foods, can help alleviate symptoms.
- Smoking Cessation: Quitting smoking and avoiding exposure to secondhand smoke can help improve symptoms of GERD.
- Eating Habits: Consuming smaller, more frequent meals throughout the day, rather than large meals, can help reduce pressure on the stomach and decrease reflux symptoms. Remaining upright for 30 to 60 minutes after eating can also aid digestion and minimize reflux.
- Posture: When bending down, it’s advisable to bend at the knees rather than at the waist to avoid putting pressure on the stomach and exacerbating reflux symptoms.
- Elevating the Head of the Bed: Raising the head of the bed by 6 to 8 inches using blocks or a wedge can help prevent stomach acid from flowing back into the oesophagus while sleeping.
- Medication: Taking medications that reduce the production of stomach acids, such as proton pump inhibitors (PPIs) or H2 receptor antagonists, as prescribed by a healthcare provider can help alleviate symptoms and prevent damage to the oesophagus.
- Medical Evaluation: If symptoms of GERD are severe, persistent, or difficult to control with lifestyle modifications and medications, it’s important to consult a doctor for further evaluation and management. They may recommend additional tests or procedures to assess the severity of GERD and determine the most appropriate treatment approach.
By implementing these strategies and seeking medical guidance when necessary, individuals with GERD can effectively manage symptoms and improve their quality of life.
Signs and Treatment of Stomach Acid Reflux in Laryngectomees:
Laryngectomees who speak through a tracheoesophageal voice prosthesis (TEP) may experience difficulties in speaking while swallowing, particularly during the passage of food or liquids through the esophageal TEP site. This can result in speech difficulties or a “bubbly” sound due to the introduction of air into the esophagus alongside food or liquids. To mitigate these challenges:
- Consume Slowly: Eating slowly and allowing food to pass through the TEP area before attempting to speak can help minimize speech disruptions.
- Blend Food with Liquids: Mixing food with liquids while chewing can aid in swallowing and reduce the risk of obstruction.
- Swallowing Exercises: Speech and language pathologists (SLPs) can teach laryngectomees-specific eating and swallowing exercises to help relearn proper swallowing techniques and improve swallowing function.
Swallowing Problems:
- Laryngectomees commonly experience swallowing difficulties (dysphagia) immediately after surgery due to the disruption of muscles and nerves involved in swallowing. While most individuals relearn to swallow with minimal issues, some may require assistance from an SLP specializing in swallowing disorders to improve swallowing function through techniques such as modifying eating habits and performing swallowing exercises.
How to Manage Food Obstruction in the Throat or Esophagus:
- Remain Calm: Remember that a laryngectomee cannot suffocate as the oesophagus is separate from the trachea.
- Try Drinking Liquid: Drinking warm liquid and attempting to force the food down by increasing pressure in the mouth may help clear the obstruction.
- Use Speech (for TEP users): Speaking through the TEP can help push the food above the TEP, relieving the obstruction.
- Change Position: Bending forward, particularly over a sink, and applying pressure over the abdomen may help clear the blockage by forcing contents upward.
- Other Techniques: Additional methods such as rubbing the throat, walking, jumping, hitting the chest or back, using a suction machine, or waiting for the food to descend into the stomach may also be attempted.
If these methods are unsuccessful and the obstruction persists, seeking medical attention from an otolaryngologist or visiting an emergency room may be necessary.
Postoperative Nutrition and NG-Tube Feeding:
- Laryngectomees typically require feeding through a nasogastric (NG) tube for two to three weeks following surgery. It’s crucial to feed slowly to prevent complications such as “dumping syndrome.”
- There is evolving evidence supporting the early introduction of clear liquids as soon as 24 hours after surgery, which may aid in muscle preservation and improve swallowing function.
Overall, managing swallowing difficulties and food obstructions in laryngectomees requires a combination of patience, techniques, and sometimes medical intervention to ensure optimal nutrition and recovery.
Handling nutrition after a laryngectomy requires special attention and care to ensure adequate intake and ease of swallowing. Here are some tips:
- Eat Slowly and Patiently: Take your time with meals, and avoid rushing through them. Eating slowly allows for better chewing and swallowing coordination.
- Take Small Bites and Chew Thoroughly: Cut food into small, manageable pieces and chew them thoroughly before swallowing. This can help prevent choking and aid in digestion.
- Blend Food with Liquid: Mix solid foods with liquid in your mouth before swallowing. Warm liquids can be particularly helpful in making swallowing easier.
- Use Liquid to Flush Down Food: If needed, use additional liquid to help flush down food. Warm liquids may work best for some individuals.
- Avoid Sticky or Tough Foods: Choose foods that are easier to swallow and digest. Some foods, such as toasted bread, yoghurt, and bananas, are typically easier to swallow than sticky or tough foods like unpeeled apples, lettuce, and steak.
- Monitor Swallowing Function: Be mindful of any changes in swallowing function over time. If swallowing problems persist or worsen, consult with a healthcare professional for evaluation and potential interventions, such as oesophagal dilation
See some of our Stoma Care Products and Labex Electrolarynx Devices!
Please consider joining our Labex Support Center for Laryngectomee FB group:.
