**6. Ready-made dense enteral feeding mixtures**

Along with the use of thickeners in the clinical practice of nutritional support in dysphagia, ready-made dense enteral nutrition mixtures are now widely used:


The positive aspect of these mixtures is, first of all, the fact that they are completely ready for use and do not require additional costs. In addition, they have good palatability based on patient preferences, are easy to use by patients, meet the needs with a minimum amount of nutrition, and maintain compliance with therapy. They are mainly high in calories (over 1.2 kcal/ml) and protein. The stable consistency of the mixtures corresponds to the adaptation of food and liquid by the type and degree of swallowing disorders. The use of ready-made mixtures is currently one of the most common medical recommendations. According to the literature, over 80% of physicians consider the intake of thickened liquids to be the most effective therapeutic strategy. One of the reasons for the widespread use of ready-made mixtures is that thickened mixtures do not require adequate cognitive and linguistic abilities. Therefore, the use of such mixtures increases the effectiveness of nutritional support [15, 32–34].

## **7. Conclusion**

Neurogenic dysphagia is a multidimensional and multifactorial problem. This syndrome is typical for many conditions with different etiology, pathogenic mechanisms, and predictable outcomes. Therefore, it is essential to select an adequate nutritional therapy, considering all the patient's characteristics. Each of the described approaches has advantages and limitations. The choice of nutritional support method depends on the degree of dysphagia, the structure of the neurological disease, and short- and long-term prognosis. Patients with mild dysphagia, especially with progressive neurological diseases, should initially be offered ready-made dense enteral feeding mixtures or specialized thickeners, according to the recommendations of a speech therapist. Acute patients with severe-to-moderate dysphagia should be fed with a nasogastric tube. If, in the next 4 weeks, a transition to *per os* feeding is not expected, a gastrostomy is required. However, we recommend that you do not overstretch with the PEG. In the process of rehabilitation, it is effective to combine nutrition through a gastrostomy tube and training of feeding through the mouth with the use of thickeners or ready-made nutritional mixtures.

*Nutrition Management in Neurogenic Dysphagia DOI: http://dx.doi.org/10.5772/intechopen.101798*
