About dysphagia
Dysphagia means 'difficulty with swallowing'. This can have many causes, including the following:
- brain injury, for example stroke or traumatic brain injury
- progressive neurological conditions, for example Parkinson’s disease or multiple sclerosis
- head and neck cancers
- dementia
- respiratory (breathing) problems such as COPD (chronic obstructive pulmonary disease)
- changes to the swallowing mechanism due to normal ageing
- deconditioning (physical and mental decline after a long stay in hospital).
Signs of dysphagia
Some of the common signs include the following:
- coughing or clearing your throat while you eat or drink (or immediately after)
- choking
- changes to the quality of your voice after you eat or drink (eg sounding gurgly or wet)
- food, drink or saliva remaining in your mouth after meals, or falling out of your mouth
- changes to your breathing pattern after you eat or drink (eg shortness of breath)
- feeling as though food is stuck in your throat
- needing an unusually long time to eat meals
- feeling embarrassed to eat and drink in public
- avoiding certain foods because they are hard to swallow
- weight loss that has no other cause
- repeated chest infections.
Risks of dysphagia
Dysphagia can cause aspiration
Your Speech and Language Therapist will carry out a swallowing assessment, to help you manage this risk (see below).
About aspiration
Aspiration happens when your food or drink goes down the wrong way. This usually means it goes into your windpipe (airway) instead of your food pipe (oesophagus). When this happens, the food or drink ends up in your lungs.
Most healthy people can cope with a small amount of aspiration.
However, if you experience aspiration often, it can cause a condition called aspiration pneumonia. Aspiration pneumonia can lead to serious complications, and can be fatal.
Some people experience aspiration without showing obvious signs of it (such as coughing). This is called silent aspiration.
Swallowing assessment
Your Speech and Language Therapist (SLT) will carry out an assessment of your swallowing. This will determine the type of swallowing difficulty you have, and check whether it is safe for you to eat and drink normally.
This assessment may take place at your bedside. Sometimes it needs you to have a further investigation such as an X-ray or an endoscopy. (An endoscopy uses a thin flexible tube, with a tiny camera on the end, to look inside your body.)
Your SLT will advise on the most suitable type of food and drink for you. Their advice will be in line with the International Dysphagia Diet Standardisation Initiative (IDDSI).
Tips to help you swallow safely
Follow this guidance when you eat or drink.
- Give yourself enough time. Do not rush.
- Sit up straight and try not to let your body lean to one side.
- Try to avoid having any distractions.
- Try to take small mouthfuls.
- Make sure your food or drink has completely cleared from your mouth and throat before you take another mouthful.
- Try not to talk and eat at the same time.
- If you find swallowing makes you tired, try to have smaller amounts more often during the day.
- Try not to eat or drink when you are feeling sleepy.
| After your assessment, your Speech and Language Therapist (SLT) will be able to help you with some personal strategies to help you swallow more easily. |
Contact information
Kingston Hospital Speech and Language Therapy (adult inpatients)