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Eating with a Tracheostomy

Having a tracheostomy usually will not affect the patient's eating or swallowing patterns. Sometimes there are changes in swallowing dynamics that require adjusting to, but it is rare that this cannot be overcome in a short time. If swallowing problems do occur, it is usually due to limited elevation of the larynx or poor closure of the epiglottis and vocal cords, which allows food or fluids into the trachea. Your otolaryngologist and speech pathologists can be consulted for an evaluation, which may include a videofluoroscopic swallowing study or other procedures to make sure the patient is swallowing safely. The speech pathologist may be able to develop ways to improve swallowing if there is a problem.

Indications of a Swallowing Problem

  • Difficulty or refusing to eat
  • Over-reaction or no reaction to food in the mouth
  • Choking and coughing while eating or drinking
  • Vomiting
  • Evidence of food in tracheostomy secretions
  • Excessive drooling
  • Large amounts of watery secretions from trach
  • Congested lung sounds
  • Frequent respiratory infections

If the patient eats by mouth, it is recommended that the tracheostomy tube be suctioned prior to eating. This often prevents the need for suctioning during or after meals, which may stimulate excessive coughing and could result in vomiting.

Encouraging fluid intake is helpful for a patient with a tracheostomy. Increased fluid intake will thin and loosen secretions making coughing and suctioning easier.

Always observe the patient while eating to be sure food does not get into the trach.