This month we welcome a guest blogger. Flora Baker is a Registered Dietician, and a good friend. I asked her to lend her expertise as a resource to A Map Through The Valley blog readers. Our first subject addresses swallowing difficulties, which may become a problem in various types of chronic illness. The topic is divided into three parts. Today is general information about dysphagia. Part 2 addresses solid foods, and Part 3 reviews liquids and community resources. Thank you, Flora!
MODIFIED DIETS: DYSPHAGIA (SWALLOWING DIFFICULTIES) PART 1
By Flora Baker MS, EdM, RD, LDN and Gail K. Kachnycz RN, MSN 24 October 2025
Nutrition is key to improving health. Mealtimes also provide opportunities for social interaction. Eating healthy foods is so important during chronic illness. However, the progressive nature of some chronic illnesses, or treatment interventions may make eating difficult. Early signs of swallowing difficulties include choking or pain when consuming solids and/or liquids. The medical term for this condition is dysphagia.
Some causes of dysphagia are due to changes in the mouth or upper part of the digestive tract, such as:
-Missing or decayed teeth
-Oral surgery or ill-fitting dentures
-Injury to the lips or other parts of the mouth
-Cancer of the mouth, esophagus, stomach
-Ulcer of the stomach
Other medical conditions can contribute to dysphagia, including:
-Head or neck injury
-Treatment or chemotherapy for any type of cancer
-Stroke or other injury to the brain
-Degenerative conditions such as dementia, Alzheimer’s disease, Parkinson’s disease
-Inactivity or bedrest weakens all muscles, including the muscles that aid swallowing
If your loved one has any of these conditions, chewing effectively or swallowing completely and safely may become an issue. Be sure to discuss this with the medical provider, especially if noticing signs such as food residual remaining in the mouth, drooling, a clear runny nose that occurs when eating, or choking/coughing when trying to swallow solids or liquids. The loved one may leave meals unfinished because chewing and swallowing solids may be tiring.
The medical provider may recommend a modified diet based on your loved one’s current condition, but changes may be needed over time. In 2019 the International Dysphagia Diet Standardisation Initiative (IDDSI) was introduced globally. The instructions for specific needs may be based on this protocol. Be sure to clarify any questions with the medical provider. The levels of modification are identified on the IDDSI website and can be used as a reference.
Here is the link for IDDSI www.IDDSI.org
From the Home Page, click “Resources” along the top of the screen. The drop-down menu includes “Patient Handouts” which give details of each level in the diet, and foods to avoid. “Videos” show exactly how to prepare and check if the food is the correct consistency.
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