Swallow Dysfunction and Choking

Dysphagia, characterized by difficulty or discomfort in swallowing, is a prevalent symptom among individuals with Huntington's Disease (HD). This condition results from the breakdown of the automatic coordination required for eating, including the actions of bringing food to the mouth, chewing, forming a bolus, and swallowing, while simultaneously inhibiting breathing. This can lead to food spillage from the mouth and inadequate chewing, with individuals often adding more food before the previous mouthful is swallowed. Poor coordination heightens the risk of frequent choking on both liquids and solid foods, and aspiration of these substances can lead to pneumonia or fatal choking incidents. Regular assessments and adaptive strategies recommended by a speech-language pathologist can significantly enhance swallowing functions and reduce choking risks. These strategies include eating slowly, minimizing distractions during meals, modifying food textures, and utilizing adaptive equipment. Additionally, it is crucial for family members to learn the Heimlich maneuver to effectively respond to choking emergencies. Maintaining adequate nutrition and hydration is feasible through careful management, which may include the use of thickening agents for beverages and pureed foods for easier swallowing. In advanced stages, gastrostomy tubes may be necessary to ensure sufficient nutrition and hydration, and discussions about tube feeding should occur early to respect the individual's preferences as expressed in an Advance Directive.