Consistencies are important for swallowing disorders. Textures are also responsible for the enjoyment of eating.
If you ask around among speech therapists in the swallowing disorder community, you'll hear a lot about consistencies. They're glad to have IDDSI—an international nomenclature for these consistencies. They swear by adjusted levels of liquids.
And yes, this is very important in neurology. Liquids are particularly problematic when swallowing. It's also clear that speech therapists have a very strong therapeutic presence in neurology.
However, the fixation on consistencies is a shame, and I say that as a speech therapist with roots in neurology!
A guest article by a speech therapist Alexander Fillbrandt .
Fixation on consistencies in swallowing and chewing disorders
There are two reasons for this. When you're new to treating people with swallowing disorders and taking your first steps in neurology (or even if you've been working there for a long time), you tend to lose sight of the fact that there are other types of swallowing disorders. The term itself is too narrow. Swallowing disorders and chewing disorders also occur in other medical fields. (The fact that chewing disorders are also somehow related to consistencies seems a bit funny at this point.)
Swallowing and chewing disorders are comparable in their effects but also differ in terms of consistencies. Where in neurology Drinks are often thicker made, people in oncology or geriatrics must have the Food is often more liquid be made.
Furthermore - and this is the second reason - Unfortunately, adjustments to consistency often result in textures being destroyed .
Textures in food and drinks?
Oh yes! Textures are what we all experience when we chew and taste. Fibers, crumbs, bits, surfaces... all of these trigger stimuli on the tongue and palate. Most of them make us enjoy eating and drinking. But they also have a physiological purpose: They help our swallowing centers make decisions.
To do this, we need to take a closer look at swallowing.
As soon as we put food in our mouth, our body begins to analyze it. We call this tasting. However, it doesn't just identify the taste to determine whether to continue with the swallowing process. The temperature is also determined. Our teeth are very good at detecting whether there are bones or hairs in the food. And also: how big the bite is and what its texture is. All of this happens consciously, i.e., rather actively.
As the swallowing process continues, the esophagus must open—actually, it is opened. But how wide and how long does this opening need to be? Exactly—that depends on the amount and consistency of the bolus, i.e., the chewed food pulp in the mouth. We no longer have conscious control over this process. It simply happens, just as breathing and heartbeat do, without us having to actively control it.
One could put it very simply and say: The consistency determines how quickly the swallow can happen, and the texture determines how long the part lasts that we can no longer control. Even more abstractly, one could say that Textures help make a sip more successful, while consistencies tend to make it more confident .
Success, safety and fun while swallowing
By the way, success and safety are the two most important functions of swallowing, from a purely medical perspective. But then eating and drinking wouldn't be fun. Then we wouldn't have to go to a café.
Fortunately, textures and taste ensure that we eat successfully, that we swallow, but also, to a very significant extent, that we enjoy it.
Marvella cakes for chewing and swallowing disorders offer a great middle ground from a speech therapy perspective. They have a uniform consistency, but still offer different textures. Especially the Apricot cake : familiar taste, consistent texture and exciting textures - a perfect combination .
We thank the author for the contribution!
