From the Guidelines
Post-stroke sensory aversions to food characteristics are likely caused by damage to brain areas responsible for taste and smell processing, as supported by the comprehensive overview of stroke patient care 1. This condition, known as post-stroke dysgeusia (taste disturbance) and dysosmia (smell disturbance), occurs when a stroke affects neural pathways in the thalamus, insular cortex, or other regions involved in sensory processing. Key factors contributing to decreased patient interest in eating include compromised level of consciousness, dysphagia, sensory and/or perceptual deficits, reduced mobility, or depression, as highlighted in the study 1. Some important considerations for managing post-stroke sensory aversions include:
- Monitoring nutritional status and preventing malnutrition, which is a significant concern as 50% of severe stroke survivors are reported to be malnourished at 2 to 3 weeks after stroke 1
- Dietary modifications with a nutritionist to find acceptable foods
- Possibly zinc supplementation to improve taste perception
- Small, frequent meals with varied temperatures and textures to help overcome aversions
- Experimenting with different seasonings, particularly umami flavors, to enhance palatability
- Addressing potential post-stroke depression with medications like mirtazapine, which may also stimulate appetite
- Maintaining a food diary to identify patterns in food acceptance and track nutritional intake Regular dental care is also crucial as oral health issues can exacerbate taste disturbances. Given the potential for gradual recovery of sensory function over months as the brain rewires through neuroplasticity, a multidisciplinary approach to treatment and ongoing monitoring of the patient's condition are essential.
From the Research
Sensory Aversions Related to Food Characteristics
- The user's question about significant sensory aversions related to food characteristics, primarily taste and smell, but sometimes texture, with an abrupt onset after a major stroke in 2014, is a complex issue that may be related to various factors.
- Research studies have investigated sensory food aversions in different contexts, including early childhood eating disorders 2 and selective eating in children, adolescents, and young adults 3.
- However, there is limited direct evidence on the specific topic of sensory aversions related to food characteristics after a major stroke.
- A study on occupational therapy practice guidelines for adults with stroke provides recommendations for interventions to improve performance and participation in daily activities and occupations, but does not specifically address sensory aversions related to food characteristics 4.
- Another study on individualized nutritional treatment for acute stroke patients with malnutrition risk improves functional independence measurement, but does not directly address sensory aversions related to food characteristics 5.
- A study on mealtime behaviors of young children with sensory food aversions provides insights into child behavior and caregiver strategy use to manage child behavior during meals, but may not be directly applicable to adults with stroke 6.
Possible Contributing Factors
- Sensory processing disorder and taste sensitivity may contribute to the development of sensory food aversions 2.
- Rigidity and sensory sensitivity may be independent contributors to selective eating in children, adolescents, and young adults 3.
- Biological and environmental factors, such as previous aversive experiences, may also play a role in the development of sensory food aversions 2.
- Anxiety disorder, autism spectrum disorder, and other behavioral problems may be associated with sensory food aversions 2, 3.