Regaining Taste After A Stroke: Is It Possible?

A stroke occurs when the blood supply to the brain is cut off, killing brain cells. This can affect the part of the brain that interprets information about taste and smell from the nose and tongue, causing changes to your senses of taste and smell. Food might taste different or bad (dysgeusia), or you may be able to taste fewer flavours (hypogeusia) or none at all (ageusia). These changes can reduce your appetite and make it harder to eat a healthy diet, increasing the risk of another stroke and impeding recovery. However, changes to taste and smell can improve over time, and good oral hygiene can help.

How does a stroke affect your sense of taste?

A stroke occurs when the blood supply to the brain is cut off, killing brain cells. This brain damage can affect a person's ability to taste and smell. Changes to these senses can be upsetting as enjoying food and drink is an important part of life, and taste and smell are closely connected to our feelings and memories.

The tongue can detect five basic tastes: salty, sweet, bitter, sour, and umami or savoury. When we eat or drink, molecules from the substance hit the taste receptors on our tongue. The taste receptors then send information through nerves into the brain, which interprets the information as tastes.

If a stroke damages the parts of the brain that interpret information about taste and smell, it can cause changes to these senses. Food might taste different or taste bad (dysgeusia). A person may be able to taste fewer flavours (hypogeusia) or none at all (ageusia). Some people lose their sense of smell (anosmia) or become more sensitive to smells (hyperosmia).

Changes to a person's sense of taste can reduce their appetite, and they might end up eating and drinking less than they need to. Alternatively, they might overeat to try to get more satisfaction from food or crave sweet or salty foods. These issues can stop a person from eating a balanced diet and impact their recovery. For example, a person with dysgeusia may increase their salt intake to improve food flavour, leading to uncontrolled hypertension.

Changes to taste can improve over time, and good oral hygiene can help. It is important to visit the dentist regularly and talk to a GP, who can help determine the cause of the problem and offer treatment and support.

What are the different types of taste problems?

There are several different types of taste problems, which can be caused by a stroke or other factors. Here is a list of some common taste problems:

• Dysgeusia is a condition where a person experiences a persistent foul, salty, rancid, or metallic taste in their mouth. It is often associated with burning mouth syndrome, characterised by a painful burning sensation. Dysgeusia can be caused by a stroke affecting the parts of the brain that interpret taste information from the tongue.
• Hypogeusia is a reduction in the ability to taste sweet, sour, bitter, salty, and umami flavours. This can be caused by poor oral hygiene, dental problems, or certain medications.
• Ageusia is the loss of taste, where a person cannot detect any flavours. This can also be caused by stroke, as well as upper respiratory infections or poor oral hygiene.
• Phantom taste perception is when a person experiences a lingering, often unpleasant taste even when there is nothing in their mouth.
• Parageusia is similar to dysgeusia, where food and drink taste distorted.
• Burning mouth syndrome is when a person experiences a painful burning sensation in their mouth, often accompanied by dysgeusia.

It is important to note that taste problems can have a significant impact on a person's life, affecting their nutrition, dietary choices, and overall health. If you are experiencing any taste problems, it is recommended to consult a doctor or otolaryngologist for diagnosis and treatment.

How does altered taste perception impact a person's life?

Changes in taste perception can have a significant impact on a person's life, especially after a stroke. Here are some ways in which altered taste perception can affect an individual:

Dietary Habits and Nutrition

One of the most immediate consequences of altered taste perception is a change in dietary habits. People may find that they can no longer enjoy their favourite foods or that certain tastes become unappealing. This can lead to a decrease in appetite and, subsequently, inadequate nutrition. As a result, individuals may experience unintentional weight loss or have difficulty maintaining a healthy weight. This can further increase the risk of post-stroke complications and hinder the recovery process.

Social Activities and Isolation

The enjoyment of sharing meals or dining out with family and friends may be diminished due to altered taste perception. Social activities that revolve around food can become less enjoyable, leading to a sense of isolation and disconnection from loved ones. This can negatively impact mental health and overall well-being.

Mental Health and Emotional Well-being

The link between taste, smell, and emotions can contribute to mental health issues. Changes in taste perception can induce or exacerbate depressive symptoms, which, in turn, may impede the recovery process. The inability to derive pleasure from food can affect mood and emotional well-being, as food is often associated with comfort and positive memories.

Quality of Life

Altered taste perception can adversely affect an individual's quality of life. It can lead to a decrease in overall life satisfaction and enjoyment of everyday activities. The inability to taste and enjoy food can impact social interactions, nutritional status, and mental health, all of which contribute to a person's quality of life.

Health Complications

Impaired taste perception can lead to unhealthy dietary choices as individuals try to compensate for the lack of taste. For example, they may increase their intake of salt or sugar to enhance flavour, leading to potential health complications such as hypertension or an increased risk of another stroke.

Daily Activities and Energy Levels

The lack of enjoyment from food can affect energy levels and motivation to engage in daily activities. Individuals may find it challenging to muster the energy to prepare nutritious meals or even to perform basic tasks. This can create a cycle of poor nutrition and decreased activity levels, further impacting overall health and well-being.

What are the treatment options for taste disorders?

Treatment for taste disorders will depend on the underlying cause. If medications are causing the problem, a doctor may ask you to stop taking them or switch to alternatives that do not affect your sense of taste. If a medical condition is the cause, treating it may eliminate the taste disorder. For example, if respiratory infections or allergies are responsible, regaining your sense of taste may be as simple as waiting for these conditions to resolve.

If oral health issues are causing the problem, brushing or scraping your tongue, and getting a professional cleaning of your teeth and gums to remove calculus, may help improve your sense of taste.

In some cases, people with a taste disorder may regain their sense of taste without any treatment.

If you have lost your sense of taste, you can try the following to make your food taste better:

• Prepare foods with a variety of colours and textures.
• Use aromatic herbs and hot spices to add more flavour, but avoid adding extra sugar or salt.
• Work with your doctor or a nutritionist to identify condiments that you can add to your diet to improve the taste of your food.
• Avoid dishes that combine different foods, such as casseroles, which can hide individual flavours and dilute taste.

What are some practical tips for managing eating difficulties after a stroke?

Eating difficulties are common after a stroke, and there are several ways to manage them. Here are some practical tips to help you:

• Trouble swallowing: This issue often improves over time, but in the meantime, it is recommended to stick to soft foods such as cooked cereal, mashed potatoes, soup, cottage cheese, and applesauce. If you want to try harder foods, cut them into small pieces or blend them to make them easier to chew and swallow. Thickening your liquids with tapioca, matzo meal, cornstarch, or banana or potato flakes can also help prevent choking.
• See a speech therapist: They can guide you through exercises to strengthen the muscles involved in swallowing, such as your tongue, lips, throat, and mouth muscles. If necessary, they may also suggest neuromuscular electrical stimulation or prescribe muscle relaxants to open your throat and ease swallowing.
• Problems using utensils: If the stroke has weakened the muscles in your arms or hands, try using flatware with larger, thicker handles that are easier to grip. Knives with curved blades can also help you cut food with one hand. Plate guards can assist in scooping food against the plate, and rubberized pads can keep your plate or bowl from sliding. Additionally, consider investing in adaptive kitchen equipment, such as easy-grip scissors, battery-powered peelers, and specialised cutting boards, to aid in one-handed cooking.
• Loss of appetite: To increase your appetite, choose foods with strong flavours and opt for colourful, nutritious options like salmon, carrots, and dark green vegetables. Eating high-calorie foods first and exercising lightly, such as walking, can also stimulate your appetite. If you wear dentures, ensure they fit well, as ill-fitting dentures can cause discomfort and reduce your desire to eat.
• No energy: Make breakfast your biggest meal of the day when you have the most energy, and simplify your last meal, opting for a sandwich or cereal. Alternatively, you can have 6 small meals throughout the day instead of 3 large ones. Buy pre-cut and pre-washed fruits and vegetables to reduce preparation time and effort. You can also ask friends and family to prepare meals that can be frozen and reheated when you don't have the energy to cook. Additionally, look into local programs like Meals on Wheels, which can deliver meals to you at little or no cost if you're over 60. Sharing meals with loved ones or visiting your local senior centre for lunch can also help ensure you're eating properly and provide you with company and assistance.

It is important to maintain proper nutrition and manage any eating difficulties after a stroke to support your recovery and reduce the risk of another stroke. If you are experiencing challenges with eating, don't hesitate to reach out to your healthcare team for guidance and support.

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