Dysphagia Awareness Month Resources
During Dysphagia Awareness Month, I typically try to share some stats and facts about dysphagia and swallowing with my social circle. This year, I decided to instead put some resources out there for patients and caregivers. I loved these resources (and the organizations that provide them) so much that I thought I would also bring them here to you!
First and foremost (dare I add “finest”?) is the National Foundation of Swallowing Disorders (NFOSD). I have sung their praises before but wanted to draw special attention to a new resource—a Virtual Support Group SPECIFICALLY for Caregivers and loved ones supporting people with dysphagia across the lifespan. The first meeting was just last month, and these are being led by a Licensed Counselor who was herself a caregiver. You can find out more here. Of course, NFOSD is practically bursting with resources for patient and caregivers, you can explore their website here.
I could also talk all day about Feeding Matters (another one I have shared before). Feeding Matters brings together patients, families, advocates and clinicians – as well as policy makers and researchers – into the same space, with shared goals. This is another site with too many resources to list, but I wanted to highlight two especially. One is their Family Assistance Program, which helps financially support families of children with feeding disorders. Families can find out more and apply here. Another is their Food Access Resources, which families can explore to find assistance with accessing food if they are struggling or need support. The entire website is worth a look!
If you are looking for patient/caregiver handouts on dysphagia diet textures, look no further than the IDDSI website. There are handouts specific to adults and pediatrics, for each level – in multiple languages. You can find them here.
A special type of patient that has always been close to my heart – the patient with dysphagia that LOVES to cook (or has a caregiver that loves to cook for them). This can be incredibly frustrating and one recommendation I have always made in this situation is to check out cookbooks that are specific to dysphagia diet textures. There are many out there, so a good place to start is this informative blog post by John Holahan. In it he gives incredibly practical tips on selecting a good dysphagia cookbook, from checking out the background of the author to making sure the photos aren’t “stock images” but show photos of what the dish actually looks like. You can read the full post here. (Full disclosure, John does have his own cookbook out there, but I did check it out and it’s very well done).
Finally, since it is Dysphagia Awareness Month, a little gift for YOU! A quick list of a few courses looking at dysphagia/swallowing through the caregiver lens. They are all free, and some are available for ASHA CEs.
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VARIBAR (barium sulfate) ABCs and FAQs
It’s getting hot out there… and it seems like our inboxes are heating up as well! We have noticed lately that we are getting an uptick in a few questions about VARIBAR products, and so I thought I would take a minute to send out some answers here!What is the carb...
INDICATIONS AND USAGE | IMPORTANT SAFETY INFORMATION
For Oral Administration. This product should not be used in patients with known or suspected perforation of the GI tract, known obstruction of the GI tract, high risk of aspiration, or hypersensitivity to barium sulfate products. Rarely, severe allergic reactions of anaphylactoid nature have been reported following administration of barium sulfate contrast agents.
VARIBAR® (barium sulfate)
INDICATIONS
VARIBAR® THIN HONEY (barium sulfate) oral suspension, VARIBAR® NECTAR (barium sulfate) oral suspension, and VARIBAR® THIN LIQUID (barium sulfate) oral suspension are radiographic contrast agents indicated for use in modified barium swallow examinations to evaluate the oral and pharyngeal function and morphology in adult and pediatric patients.
VARIBAR® HONEY (barium sulfate) oral suspension and VARIBAR® PUDDING (barium sulfate) oral paste are radiographic contrast agents indicated for use in modified barium swallow examinations to evaluate the oral and pharyngeal function and morphology in adult and pediatric patients 6 months of age and older.
IMPORTANT SAFETY INFORMATION
CONTRAINDICATIONS
These products should not be used in patients with known or suspected perforation of the gastrointestinal (GI) tract; known obstruction of the GI tract; high risk of GI perforation such as those with a recent GI perforation, acute GI hemorrhage or ischemia, toxic megacolon, severe ileus, post GI surgery or biopsy, acute GI injury or burn, or recent radiotherapy to the pelvis; high risk of aspiration such as those with known or suspected tracheo-esophageal fistula or obtundation; known severe hypersensitivity to barium sulfate or any of the excipients of the product used.
WARNINGS AND PRECAUTIONS
Hypersensitivity Reactions Barium sulfate preparations contain a number of excipients, including natural and artificial flavors, and may induce serious hypersensitivity reactions. The manifestations include hypotension, bronchospasm and other respiratory impairments, and dermal reactions including rashes, urticaria, and itching. A history of bronchial asthma, atopy, food allergies, or a previous reaction to a contrast agent may increase the risk for hypersensitivity reactions. Emergency equipment and trained personnel should be immediately available for treatment of a hypersensitivity reaction.
Intra-abdominal Barium Leakage The use of VARIBAR PRODUCTS is contraindicated in patients at high risk of perforation of the GI tract. Administration of VARIBAR PRODUCTS may result in leakage of barium from the GI tract in the presence of conditions such as carcinomas, GI fistula, inflammatory bowel disease, gastric or duodenal ulcer, appendicitis, or diverticulitis, and in patients with a severe stenosis at any level of the GI tract, especially if it is distal to the stomach. The barium leakage has been associated with peritonitis and granuloma formation.
Delayed Gastrointestinal Transit and Obstruction Orally administered barium sulfate may accumulate proximal to a constricting lesion of the colon, causing obstruction or impaction with development of baroliths (inspissated barium associated with feces) and may lead to abdominal pain, appendicitis, bowel obstruction, or rarely perforation. Patients with the following conditions are at higher risk for developing obstruction or baroliths: severe stenosis at any level of the GI tract, impaired GI motility, electrolyte imbalance, dehydration, on a low residue diet, taking medications that delay GI motility, constipation, pediatric patients with cystic fibrosis or Hirschsprung disease, and the elderly. To reduce the risk of delayed GI transit and obstruction, patients should maintain adequate hydration after the barium sulfate procedure. When administering VARIBAR PUDDING, consider the administration of laxatives.
Aspiration Pneumonitis The use of VARIBAR PRODUCTS is contraindicated in patients with trachea-esophageal fistula. Oral administration of barium is associated with aspiration pneumonitis, especially in patients with a history of food aspiration or with compromised swallowing mechanism. Vomiting following oral administration of barium sulfate may lead to aspiration pneumonitis. In patients at risk for aspiration, begin the procedure with a small ingested volume of VARIBAR PRODUCTS. Monitor the patient closely for aspiration, discontinue administration of VARIBAR PRODUCTS if aspiration is suspected, and monitor for development of aspiration pneumonitis.
Systemic Embolization Barium sulfate products may occasionally intravasate into the venous drainage of the GI tract and enter the circulation as a "barium embolus" leading to potentially fatal complications which include systemic and pulmonary embolism, disseminated intravascular coagulation, septicemia and prolonged severe hypotension. Although this complication is exceedingly uncommon after oral administration of a barium sulfate suspension, monitor patients for potential intravasation when administering barium sulfate.
ADVERSE REACTIONS
The most common adverse reactions are nausea, vomiting, diarrhea, and abdominal cramping. Serious adverse reactions and fatalities include aspiration pneumonitis, barium sulfate impaction, intestinal perforation with consequent peritonitis and granuloma formation, vasovagal and syncopal episodes.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Please click here for full Prescribing Information for VARIBAR® THIN LIQUID (barium sulfate) oral suspension.
Please click here for full Prescribing Information for VARIBAR® THIN HONEY (barium sulfate) oral suspension.
Please click here for full Prescribing Information for VARIBAR® NECTAR (barium sulfate) oral suspension.
Please click here for full Prescribing Information for VARIBAR® HONEY (barium sulfate) oral suspension.
Please click here for full Prescribing Information for VARIBAR® PUDDING (barium sulfate) oral paste.
VARIBAR is manufactured by E-Z-EM Canada Inc., for E-Z-EM, Inc., a subsidiary of Bracco Diagnostics Inc., Princeton, NJ 08540.
VARIBAR is a registered trademark of E-Z-EM, Inc.
INDICATIONS AND USAGE | IMPORTANT SAFETY INFORMATION
Do not use in cases of known or suspected esophageal obstruction or to dislodge foreign bodies. Do not use more than the maximum recommended dosage in 24‐hour period. Do not use the maximum dosage of this product for more than two weeks, except under the advice and supervision of a physician.
Talk Soon,
US-VARH-2500014 12/25