Information for Healthcare Professional Use Only In this episode of the Inside Medical Nutrition podcast, Dr. Linia Patel interviews Smruthi Venkat, a speech and language therapist (SLT) specialising in stroke rehabilitation. They delve into the complexities of dysphagia, swallowing difficulties commonly experienced by stroke patients. Smruthi explains that stroke patients present with varying swallowing impairments depending on the location of the stroke. These can include oral motor weakness, sensory deficits affecting the ability to distinguish food temperatures or detect residue, and impaired coordination of the four-stage swallowing process. The conversation highlights the importance of early swallow screening for stroke patients upon hospital admission. If difficulties are detected, a specialist assessment by a speech and language therapist is crucial. This bedside swallowing assessment involves a detailed case history, cranial nerve and oral motor examination, and observation of the patient consuming different food and fluid textures. Smruthi emphasises the role of the International Dysphagia Diet Standardisation Initiative (IDDSI) framework in determining safe food and fluid textures. If a patient is deemed unsafe or silent aspiration is suspected, further instrumental assessments like video fluoroscopy or endoscopy are recommended. The podcast also explores the Eating, Drinking, and Swallowing Competencies Framework developed by the Royal College of Speech and Language Therapists (RCSLT). These competencies provide standards for knowledge, skills, and understanding for professionals supporting individuals with eating and drinking difficulties. Smruthi shares how these competencies have informed training programs and improved the quality of care for dysphagia patients. Finally, the discussion covers stroke rehabilitation guidelines, emphasising the potential for patients to benefit from rehabilitation at any point after their stroke. Smruthi outlines various rehabilitation options, including texture modification, behavioural  therapy, and exploratory muscle strength training. She underscores the importance of a collaborative, multidisciplinary team approach involving physicians, nurses, therapists, dietitians, and psychologists to support the patient's recovery journey. Smruthi highlights the importance of oral hygiene for stroke patients, following SLT recommendations, and stroke rehabilitation. Listen to the full podcast episode to learn more about dysphagia and how dysphagia is managed in stroke rehabilitation patients.

Dr Rosan Meyer, a Paediatric Dietitian, discusses the Cow’s Milk related Symptom Score (CoMiSS) and how it can help healthcare professionals to be more aware of symptoms related to Cow’s Milk Allergy (CMA) and support the diagnosis of CMA. You can access the CoMiSS tool here. Information for Healthcare Professional Use Only

Information for Healthcare Professional Use Only In this episode of the Inside Medical Nutrition podcast, Dr. Linia Patel interviews dietitians Jamie Leung and Sam Ogundere about blended diets in transitional care. Jamie and Sam discuss their roles supporting patients needing enteral feeding, as they observe  an increasing number of adults requiring blended diets. They highlight the variety of conditions necessitating enteral feeding tubes, including stroke, MND, Parkinson's, and cancer. The conversation explores the use of homemade blended diets, with Jamie estimating that around 5% of their paediatric caseload relies entirely on blended diets, while 30% use them partially. They share positive experiences regarding tolerance and the natural inclination of parents to blend familiar foods. Challenges include inconsistent support from schools and the resource demands of administering blended diets. The discussion shifts to tube feeds with food-derived ingredients, which both dietitians embrace as a valuable option, particularly for parents with limited time, small kitchens, or financial constraints. They acknowledge that awareness of these options is still growing, and that initial management often focuses on medical solutions. Jamie and Sam emphasise the importance of open-mindedness, flexibility, and parental involvement in blended diet management. They recommend the EPSGHAN guideline for children and the BDA toolkit as helpful resources. The need for risk assessment forms, information leaflets, and nutritional analysis programs is also highlighted. Finally, they discuss transitional care, emphasising the crucial role of multidisciplinary teamwork and communication. They stress the importance of a joint visit to ensure a smooth handover and address any concerns. The podcast concludes with a call for continued research and greater awareness of blended diets for patients requiring enteral nutrition. Listen to the full podcast episode to learn more about blended diets in transitional care and how best to support patients requiring enteral feeding.