Swallowing Problems (Dysphagia)
What is Dysphagia?
Dysphagia means difficulty with swallowing.
A person with dysphagia might:
- Struggle to hold food or drink in their mouth
- Have trouble chewing or moving food around
- Find it hard to swallow at the right time
- Not protect their airway properly when swallowing
- Feel like food gets stuck or doesn’t go down easily
What causes it?
Dysphagia can happen if the swallowing muscles are weak or damaged, or if someone is less aware of what’s in their mouth.
It can be caused by:
- Stroke or head injury
- Conditions like Parkinson’s, MS, or Motor Neurone Disease
- Some lung or respiratory problems
Why is Dysphagia a problem?
Swallowing problems can be serious. Food or drink might go “down the wrong way” into the lungs instead of the stomach — this is called aspiration, and it can lead to chest infections or pneumonia.
If not managed properly, dysphagia can also cause dehydration and malnutrition.
Can It Get Better?
Recovery depends on the person and their condition. Your speech and language therapist (SLT) can explain what to expect and give advice.
Common signs of Dysphagia
- Coughing or choking when eating or drinking
- Wet or gurgly voice after swallowing
- Shortness of breath after swallowing
- Feeling like food is stuck
- Difficulty chewing
- Leftover food or drink in the mouth
- Avoiding certain foods or loss of appetite
- Losing weight
- Frequent chest infections
Tips for safer swallowing
- Sit upright when eating or drinking (ideally in a chair)
- Don’t lean forward, back, or to the side
- Don’t tip your head back
- Take small bites and sips
- Eat and drink slowly
- Chew thoroughly
- Avoid eating if tired or unwell
- Don’t mix food and drink in the mouth
- Avoid talking while eating or drinking
- Limit distractions (TV, radio)
- Only use straws or spouts if advised
- If you wear dentures, make sure they fit well
- Stay upright for at least 15 minutes after meals
Who can help?
Speech and Language Therapists (SLTs): They assess swallowing and suggest safe foods and drinks. If your swallowing is unsafe, it may be necessary to remain nil by mouth (NBM). Your doctor may recommend that you have a temporary nasogastric feeding tube (NG tube).
- Dietitians: Help with nutrition and hydration
- Physiotherapists: Help improve sitting posture
- Occupational Therapists: Suggest helpful tools or tips for eating/drinking
- Nurses: Help with mealtimes and oral hygiene
- Pharmacists: May suggest alternatives if tablets are hard to swallow
Food Texture Changes
After assessment, you might need to change how food is prepared (e.g. made softer). These textures follow international guidelines to reduce choking risks.
See the Food Texture page for more info.
Why Use thickened drinks?
If swallowing is unsafe, your SLT may recommend thickened drinks. Thicker drinks move more slowly, making them safer to swallow and less likely to enter the lungs.
How to use a Thickener (e.g. Thicken Up Clear)
- Measure 200ml of your drink (e.g. water, tea, juice)
- Add the correct number of flat scoops of thickener to an empty cup (as advised by your SLT)
- Pour the drink over the powder
- Stir straight away until fully mixed
- Let it stand:
- 1 minute for water, tea, coffee
- A few minutes for juice or milk
Important:
Check consistency before serving if made in advance. Ask your SLT if you take supplements — they may need different thickening methods.
Other recommendations for safer drinking may include:
- Sit as upright as possible when having a drink – ideally in a chair
- Avoid tipping your head back to swallow
- Take small mouthfuls
- Take one sip at a time
- Take a rest from drinking if needed
- Try not to mix mouthfuls of food and drink together
- Don’t drink if you’re feeling too tired or unwell – wait until later
- Avoid distractions or talking whilst drinking
- Don’t use spouts or straws, unless they’ve been specifically recommended
