Water Jelly Ingestion Is Beneficial for Aspiration Pneumonia in Older Patients With Moderate to Severe Dysphagia

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Investigators assessed the efficacy of water jelly ingestion for rehabilitation and aspiration prevention in older patients with moderate to severe dysphagia.

Water jelly ingestion may be effective for rehabilitation and prevention of aspiration pneumonia among older patients with moderate to severe dysphagia, according to a study in the Journal of Clinical Gastroenterology. The findings are based on 2 retrospective analyses of clinical outcomes from a single center in Japan.

In study 1, researchers conducted an endoscopic swallowing assessment in patients with dysphagia who were hospitalized from January 2015 to December 2018 and had a Hyodo-Komagane score of 8. A total of 36 patients (18 women) with a mean age of 82±9 years were included. A Food Intake Level Scale was used to compare food intake levels between patients with and without water jelly (50 to 100 mL) ingestion training 3 times per day.

In study 2, 64 patients (35 men) hospitalized with aspiration pneumonia from January 2018 to November 2019 with a mean age of 81±9 years were included. The investigators compared the number of patients with aspiration of any form or amount of diet from the trachea or new aspiration pneumonia during hospitalization between the groups with and without cyclic ingestion of jelly immediately after each meal.

In study 1, 3 patients (25%) who continued to undergo water jelly ingestion training were able to eat at least 1 pureed diet (level 5, 2 patients; level 6, 1 patient), and none of the 24 patients who did not undergo the training were able to eat any form of diet (levels 5 and 6, no patients) — 25% (3/12) vs 0% (0/24) (P =.011).

In study 2, the number of participants who aspirated food from the trachea and who developed new aspiration pneumonia in the group with cyclic ingestion was significantly lower compared against the group without cyclic ingestion — 6% (2/34) vs 27% (8/30) (P =.022); 0% (0/34) vs 17% (5/30) (P =.031).

Study limitations include the small sample size from a single hospital in Japan. Additionally, it was not possible to completely eliminate the effect of patients’ background and confounding factors, and neither esophageal manometry nor radiography were used in any of the participants.

“[W]ater jelly ingestion training is expected to be an effective method for rehabilitation even in dysphagia patients who have difficulty continuing rehabilitation,” stated the researchers. “In addition, cyclic ingestion with water jelly immediately after each meal may reduce the risk of aspiration pneumonia in the elderly with moderate to severe dysphagia.”


Morita A, Horiuchi A, Horiuchi I, Takada H. Effectiveness of water jelly ingestion for both rehabilitation and prevention of aspiration pneumonia in elderly patients with moderate to severe dysphagia. J Clin Gastroenterol. 2022;56(2):e109-e113. doi: 10.1097/MCG.0000000000001493