Dysphagia and Nutrition

Once again, in this further editorial effort, Antonio Amitrano demonstrates his ability to argue about a human function-now the case of swallowing-not only with the scientific rigor of the health professional but also with the curiosity of someone who seeks to understand and explain the reasoning behind the various customs that accompany this function and, last but not least, with the humanity of those who address not only the patient but also the individual-whether man, woman, or child-deprived of the joy that sitting at the table to eat can bestow.This multifaceted approach has already characterized The Voice: A Tool of Professionals Who Promote Health, a book published in 2004, which I had read with enthusiasm, fascinated by the 1000 facets in which the voice was reflected and analyzed.In Dysphagia and Nutrition: The Meal of a Patient with Swallowing Disorders, the same apparatus that, in the most recent phylogenetic evolution, has allowed people to communicate with voice and speech, is analyzed in terms of its primordial and vital functions, ensuring the supply of nutrients and the defense of the respiratory tract.The first part of the volume, enriched by numerous anecdotes and historical and cultural references, describes everything that the meal has represented and represents for the human being in terms of sharing, sociability, and joy of living.This first part is a necessary premise, even if previously neglected in other texts, to understand the importance of focusing all efforts on fully recovering oral feeding (per os) in pathological cases or, if not possible, making swallowing "functional," or possible with some tricks, as pleasant and rewarding as possible, thus transforming it into a moment of pleasure and sociability.The second part of this book describes in detail the physiology and pathophysiology of swallowing and the diagnostic and rehabilitative path that patients with swallowing disorders must undergo.As far as the discussion follows the traditional canons of deglutology doctrine, there are references to tests and techniques recently introduced.Of particular interest is the description of diagnostic methods, such as meal observation, the result of the author's long field experience.Over the past 30 years, interest in swallowing disorders has spread to involve most health professionals, particularly those who carry out their activities in hospitals and residential facilities for elderly individuals.I believe that reading this volume can offer each of them not only useful technical knowledge to safeguard the viii health of patients but also essential food for thought, encouraging consideration of feeding problems also from the patient's perspective, thus adopting a broader view that is necessary to optimize therapeutic intervention.