Frequent complications associated with Huntington’s disease include problems with eating and swallowing. Weight loss often is associated with the disease, so people with Huntington’s disease and their caregivers should seek professional advice to make sure they eat nutritious foods with a lot of calories that are easy to consume.
Eating and swallowing problems
Huntington’s disease patients have a tendency to choke on food due to a lack of fine motor control (control of small muscles). They often experience enormous increases in appetite and sometimes trying to eat quickly to satisfy urgent hunger can lead to choking. Irregular spasms in the diaphragm increase the risk of inhaling food rather than swallowing it.
Weight loss is common in Huntington’s disease and many people with the disease have a low weight in relation to their height. This is due not only to difficulties encountered with ingesting food, but also changes the disease causes in the body.
In early Huntington’s, supporting good nutrition is a primary concern. As the disease progresses, and chewing and swallowing become challenges, there are measures that can be taken to facilitate eating. As the disease progresses, patients may experience aspiration pneumonia caused by inhaling food, stomach acid, or saliva into the lungs. In late stages of the disease, the use of a feeding tube may be recommended to make sure patients receive proper nutrition.
A feeding tube is one alternative for people who are struggling with eating, drinking, and maintaining weight. Using a feeding tube is not an easy decision to make, and people are advised to consider it before crises arise. Feeding tubes, also called gastronomy tubes, are plastic tubes placed through a small hole in the abdominal wall and into the stomach. They allow for liquid nutrition to be provided to the patient.
The spot where the tube is inserted must be cleaned daily and can become sore or tender due to involuntary movements that cause arms or legs to push against the area.
When there are repeated cases of aspiration pneumonia and a fear of choking, a feeding tube may be suggested after a swallowing evaluation and nutritional assessment are performed.
Since mealtimes are a meaningful social event, as well as a time to satisfy hunger, making the occasion as pleasant and relaxed as possible is important. Eating can be a challenge for patients with Huntington’s disease and can cause significant stress, worsening the chorea, and subsequently making eating even more difficult.
The advice of a dietician who understands the challenges faced by people with Huntington’s and their families should be sought. As a general rule, having frequent small meals instead of three main meals spaced widely apart, with second helpings available, can make mealtimes easier. Also, soft, easy-to-chew and easy-to-swallow foods are recommended.
Foods that contain anti-oxidants, fruits and vegetables, and healthy fats are all recommended for Huntington’s patients. Some foods are to be avoided, such as aged cheeses, liverwurst, and red meat because they may have a harmful interaction with drugs often taken by Huntington’s patients, such as anti-anxiety drugs, anti-depressants, and antipsychotics.
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