[Dysphagia] cricopharyngeal diet

[OdonneK at doh.health.nsw.gov.au (Kimberley ODonnell)]

Hi all
Please excuse my ignorance, hopefully just due to the fact that I am from Australia, but what is a goldfish cracker and what does RD stand for?
Thanks in advance.
Kim

Kimberley O'Donnell
Speech Pathologist - BAppSc MSPAA CPSP
Royal Rehab. Centre Sydney
ph:(02) 9808 9210 or (02) 9807 1144 - pager 48
59 Charles Street   RYDE   NSW 2112

>>> Michel Sanscartier <m.sanscartier@videotron.ca> 14/09/2005 9:04:48 am >>>
That is something else!

Cricopharyngeal diet!!!



First, as I always answer to that group, why don't you ask the

RD you work with?

Linda, did you ask him or her?

Did you ask her also to discuss with you if the patient had an esophageal
dysphagia.

I know that in the US, RDs don't dare to do much in upper dysphagia
problems.

BUT, they know a lot in esophageal dysphagia and they work everyday with
that.

GERD and all the esophageal problems is clinical nutrition 101 for us.



Second, viscosity is for liquid PLEASE.



A FOOD properties analysis is a class that all RD take (at least in Canada).

There are many levels of organoleptic properties of food but only 3 are
relevant for dysphagia:



- Texture for all food (machines, utensils and mouth can measure it).

Texture is usually used in the industry for solid food. The qualifying would
be : hard, soft, puree, * (there are at least 25 others).



- Consistency is an empirical measure that can be defined by a consistometer
(there's honey, nectar and clear consistencies). It's like asking: what is
your height: the answer would tall or short or medium. The liquid is
submitted to the gravity. The little metal container cost over $500 us last
time I called.



- Viscosity is measure by a viscosimeter. That little machine cost over $10
000 us.

It's precise but as you will probably read soon, there's no link between
viscosity of liquids and consistency (except maybe for honey). The measures
are in Kpascal / sec or in centipoise. It's like asking someone the same
question: what is your height: in that case, the answer would be 152 cm or 5
feet.



I'm sure that the RD you work with could have told you the same things.



Third, if your patient has a Wallenberg syndrome or a stroke that wasted his
CN IX, X and/or XI there are many things that you could try. You probably
know it for rehab (Mendelson) but the diet? Please, work with the RD from
your hospital. I sincerely hope that RDs will become more involved in
dysphagia. We can make a great team, I know it.



In case someone corrects my mistakes like that last time, please know that
I'm a French Canadian speaking and that I'm far from being perfect
bilingual. I'm doing my best here.




Michel Sanscartier RD, MSc
1900 rue Beaudry
Montr?al, Qc
H2L 3E9
514-522-3847
m.sanscartier@videotron.ca
----- Original Message -----
From: <sorriso@adelphia.net>
To: "dysphagia listserv" <dysphagia@b9.com>
Sent: Tuesday, September 13, 2005 5:23 PM
Subject: [Dysphagia] cricopharyngeal diet


> There has been a discussion going on on the ASHA Division 13 list
> regarding what the heck a cricopharyngeal diet is.  In response to a post
> requesting assistance with a patient, one therapist suggested a
> cricopharyngeal diet, prompting the question, "what is it?"
>
> We've come to learn that it stems from vitalstim education and the
> identification of and significance of cricopharyngeal dysfunction in
> dysphagia.  The diet evidently refers to a solid food's viscosity and fat
> content in that a goldfish cracker is "better" than applesauce for the
> identified patient.  No research evidence has been cited in the
> discussion.
>
> There, you know as much as I do (for those of you who didn't already
> know).
>
> My question to this list is, what do you know about the cricopharyngeal
> diet?  Can you add more to the discussion?  Is this a valid premise?  Is
> there research?
>
> Linda A. Zanchi, MA CCC-SLP
> _______________________________________________
> Dysphagia mailing list
> Dysphagia@b9.com
> http://lists.b9.com/mailman/listinfo/dysphagia
>




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