The role of gut microbiota-immune axis in swallowing dysfunction and nursing interventions

Dysphagia constitutes a growing global health burden, particularly among geriatric and post-stroke populations. Although traditionally managed through biomechanical interventions, emerging evidence underscores the microbiota-immune axis as a critical modulator of systemic resilience and clinical outcomes. This review delineates how dysphagia drives systemic dysbiosis via three primary mechanisms: dietary modification, descending migration of oral pathogens along the oral-gut-lung axis, and iatrogenic pharmacological effects. A core pathological consequence is the depletion of microbial metabolites, especially short-chain fatty acids (SCFAs), which undermines neurological recovery and musculoskeletal integrity through the gut-brain and gut-muscle axes. Such dysbiosis further weakens intestinal barrier function, precipitating endotoxin translocation, chronic systemic inflammation, and elevated risk of life-threatening complications like aspiration pneumonia. Consequently, nursing practice should integrate microbiome-targeted strategies. Key interventions encompass nutritional modulation with specific probiotics (e.g., Lactobacillus rhamnosus GG) and prebiotics to restore SCFA levels, enhanced oral care to minimize pathogen reservoirs, and pharmacological stewardship to mitigate iatrogenic microbial disruption. Adopting these tailored approaches, these can transit nursing care from compensatory support to actively promoting physiological recovery and immune resilience in dysphagia patients.