Swallowing Disorders in Adults

About Swallowing Disorders

We all have problems swallowing sometimes. We may have trouble chewing a tough piece of meat. We may gag on food or have to swallow hard to get it down. And we have all had a drink “go down the wrong way,” making us cough and choke. A person with a swallowing disorder will have trouble like this a lot of the time. A swallowing disorder is also called dysphagia (dis-FAY-juh).

Swallowing happens in three stages, or phases. You can have a problem with one or more of these phases. They include:

• Oral phase (mouth)—sucking, chewing, and moving food or liquid into the throat.
• Pharyngeal phase (throat)—starting the swallow and squeezing food down the throat. You need to close off your airway to keep food or liquid out. Food going into the airway can cause coughing and choking.
• Esophageal phase—opening and closing the esophagus (the tube that goes from the back of your throat to your stomach). The esophagus squeezes food down to the stomach. Food can get stuck in the esophagus. You may also throw up a lot if there is a problem with your esophagus or if you have acid reflux (commonly known as indigestion or heartburn).

Signs of Swallowing Disorders

Signs of a swallowing problem might include:

• coughing during or right after eating or drinking
• clearing your throat often after eating or drinking
• having a wet or gurgly voice during or after eating or drinking
• feeling like something is stuck in your throat or chest after eating or drinking
• needing extra work or time to chew or swallow
• having food or liquid leak from your mouth
• food getting stuck in your mouth
• having a hard time breathing after meals
• losing weight

A swallowing problem might cause you to have these conditions:

• dehydration or poor nutrition
• food or liquid going into the airway, called aspiration
• pneumonia or other lung infections
• reflux

Some people with swallowing problems feel embarrassed when eating or feel badly about their swallowing problems and want to eat alone.

Causes of Swallowing Disorders

Many conditions can cause swallowing problems. Some medications can cause dry mouth, which makes it hard to chew and swallow. Other causes include:

• dry mouth, which makes it hard to chew and swallow
• damage to your brain or nerves, like from a stroke, a brain injury, or Parkinson's disease
• problems with your head, neck, or mouth, like cancer or an injury

For more information about how head and neck cancer can effect swallowing, please see Swallowing Problems From Head and Neck Cancer Treatment.

Testing for Swallowing Disorders

An SLP can test you to see how you eat and drink. You will want to see an SLP who works with adults with swallowing problems. The SLP will:

• Ask you about your health, past illnesses, surgeries, and swallowing problems.
• See how well your mouth muscles move.
• Watch you eat to see how you sit, how you feed yourself, and what happens when you swallow.
• Do special tests, if needed. The SLP can watch how you swallow using:
  • Modified barium swallow. You eat or drink food or liquid with barium in it. Barium shows up on an X-ray so the SLP can watch where the food goes.
  • Endoscopic assessment. The doctor or SLP puts a tube with a light on the end of it into your nose and down into your throat. This tube has a camera on it, and the SLP can watch you swallow on a screen.

Treatment for Swallowing Disorders

The treatment you need will depend on the problems you have. You may need medical treatment from a doctor, such as medicine for reflux. You may need to get nutrition in ways other than eating. These may include a tube through your nose or in your stomach. Your doctor will work with you if you need tube feeding.

The SLP can work with you to improve how you swallow. They may suggest:

• Treatment to help you use your muscles to chew and swallow.
• Instruction on ways you should sit or hold your head when you eat.
• Strategies to help you swallow better and more safely.
• Eating softer foods or drinking thicker drinks to help make swallowing easier.

Your family or caregivers can help you by:

• Asking any questions you have to understand your swallowing problem and what the SLP will work on.
• Following your SLP’s suggestions.
• Helping you with exercises.
• Helping you get food and drinks that you can swallow safely.
• Keeping track of how much you eat and drink.

To find an SLP or audiologist near you, visit ProFind.

Other Resources

Inclusion on this list does not imply endorsement.

• Board-Recognized Specialists in Swallowing and Swallowing Disorders
• Medline Plus – National Library of Medicine
• WebMD