Swallowing problems (also known as dysphagia) are common among people with Huntington's disease. Statistics have repeatedly shown that the number one cause of death among person with Huntington's disease is aspiration pneumonia. This can occur when food or liquid enters the airway rather than the esophagus during eating or drinking, and then forms a collection in the lungs that can become a pneumonia. The following is a list of swallowing problems with Huntington's disease.

• Difficulty controlling amount of food or liquid intake
• Difficulty controlling rate of food or liquid intake
• Delayed swallow reflex
• Holding food in mouth
• Inability to swallow
• Chorea of the oral or pharyngeal muscles (tongue, lips, jaw, throat, esophagus)

The following is a list of strategies for safe swallowing:

• Provide small bites and sips
• Alternate bites with sips to help wash down food
• Swallow twice for every bite or sip to clear residuals from the mouth
• Use gravies, sauces, and condiments with dry foods or solids whenever possible
• Crush medications in applesauce if a person is on a pureed diet
• Avoid distractions during oral intake (no TV, quiet setting, donít eat when tired or upset)
• Swallow with head tilted down so that chin points to the chest (a pillow or rolled towel behind the head may be helpful for keeping head in this position)
• Stay seated upright for 20-30 minutes after a meal or a snack
• Thickened liquids are generally easier to swallow (a commercial thickener can be purchased which allows you to thicken any liquid to any consistency desired)
• Avoid acidic and spicy foods (if aspirated, these types of food are more likely to cause a pneumonia)

Here are some suggestions for cookbooks for caregivers of people with Huntington's disease. Be sure to take the person who has Huntington's disease to see someone who specializes in swallowing problems (a speech and language pathologist) and have a Videofluoroscopic Swallow Study done before trying out any of these cookbooks. Everyone is different and depending on where or what point during swallowing things go wrong, it may not be safe to use the recipes in these cookbooks.

• Non-Chew Cookbook: A cookbook by J. Randy Wilson for people suffering from chewing, swallowing and dry mouth disorders. It contains 200 recipes and sells for $23.95. Information is available by calling 800-843-2409.
• Puree & Fancy: A collection of recipes and mealtime enhancements specially created for modified-consistency diets by Diafoods Thick-It. Information is available by calling 800-333-0003.