Ice Cream Diet: When You Can Only Tolerate Soft Foods

A year ago, if someone had told me I was going to be living on ice cream, yogurt, and smoothies, I’d have been pretty happy. When I actually have to do it, I dread my next meal. 

For once, I don’t want to eat. Every swallow hurts. 

I was encouraged to eat a diet of soft foods, like yogurt and ice cream, until additional medical testing could be completed. So, I bought three flavors of ice cream and four of yogurt. I bought flavors and brands I like regardless of the price, telling myself I’d need the calories if everything else hurts too much.

But the fact is, even a bowl of warm, melted ice cream is hard for me to get through. It tastes good in my mouth, but I get stabbing pains along my esophagus once food or beverages enter it. And doctors don’t know why yet.

Dysphagia

I have a diagnosis—dysphagia—a generic term for problems swallowing.

This is fairly common in the older adult population I work with, affecting 15-20% of people over age 60. But it can occur in children and young adults, such as myself. 

I don’t know yet why I personally developed it, but here are possible causes: 

-Tumor

-Infection and inflammation

-Food stuck in my esophagus

-Intubation during surgery or and ICU stay 

-Reflux, which can cause esophageal spasms, scars, and narrowing

Diet

Everyone with dysphagia is different and their diet will be tailored to them, usually by a Speech Language Pathologist. 

Under the National Dysphagia Diet from the American Speech-Language-Hearing Association, there are four levels of food texture: regular, advanced, mechanical altered, and pureed.  However, healthcare facilities may not have four levels or may call them different names, such as “soft,” “ground,” and/or “chopped” diets.

Fruit cups with diced or pureed fruit are okay on mechanical diets.

I’m following what my facility calls a mechanical soft diet, which is not literally only ice cream, yogurt, and smoothies. It includes soft grains, like oatmeal; skinless, cooked vegetables; and canned, diced fruit. Ground meat mixed with gravy is also allowed on this diet, but I avoid meat and have been consuming tofu and dairy for my protein.  

Although most people do not enjoy having their diet restricted to soft or pureed foods, such diets are usually prescribed due to concerns that harder, chewier food could be dangerous. Similarly, most people prefer thin liquids but they may be advised to consume nectar-thick, honey-thick or pudding-thick liquids because thin liquids, including ice cream and gelatin, may accidentally enter the lungs instead of the stomach. 

A small amount of people with dysphagia are not allowed to eat and instead receive tube feedings. One study found that only 5% of older adults with dysphagia received tube feedings.

Good News

While dysphagia isn’t pleasant, it’s not always permanent either. I have seen patients on pureed food with honey-thickened liquids return to eating regular food with regular thin liquids.

Additional Reading 

For more information on dysphagia, I recommend the American Speech-Language-Hearing Association and this article by Livia Sura, Aarthi Madhavan, Giselle Carnaby, and Michael Crary.
For lists of what patients can and cannot eat on puree and mechanical soft diets, visit the Memorial Sloan Kettering Cancer Center website. 

Do you or a loved one have a personal experience with this? What was the hardest part and how did you cope?

Disclaimer: If you have or think you have dysphagia, please speak to a doctor, Speech Language Pathologist, or Registered Dietitian regarding your diet. The information provided here is not intended to diagnose or treat any medical condition.