Difficulty Swallowing

Dysphagia is the medical term for swallowing difficulties. People with swallowing difficulties sometimes feel pain when they swallow, have difficulties swallowing certain foods, saliva or liquids and some are unable to swallow safely. 
Swallowing difficulties can come and go, and can change over time causing other symptoms such as weight loss, dehydration or constipation. Some signs of swallowing difficulties are:

  • Coughing or choking when eating or drinking,  
  • Feeling like something is stuck in your throat, 
  • Pain when you swallow,
  • Bringing food back up, sometimes through your nose, and/or
  • Losing weight because you can’t eat enough food or drink liquids.

Swallowing difficulties can be caused by a few things, such as a dry mouth or infection. Other causes can be: 

  • Chronic conditions: Like cancer of the head, mouth or neck. People with dementia and memory loss sometimes find it hard to chew or swallow safely. 
  • Treatments: Chemotherapy or radiation, especially to the head, neck and upper chest may cause swelling or irritation in your mouth or throat.
  • Other symptoms/conditions: That affect your brain such as a stroke or head injury. 

Managing swallowing difficulties works best when you play an active role. 

  • Try to figure out if there is a cause for your swallowing difficulties. 
  • Is it better or worse at different times?
  • What helps or makes it worse?

You may want to use a symptom diary to record information about your swallowing difficulties. Tracking this information will help you talk to healthcare team about your swallowing difficulties.

 Physical things you can try:

  • Medication: If you take medication for your swallowing problems, take it as prescribed so your symptom doesn’t get too bad.
  • Change your diet: Changing the types of food you eat and how they are prepared might help. Cut food into small bites and use a small spoon for eating smaller portions of food. Avoid putting too much food into your mouth at once.
  • Eat slowly: Take your time to chew and swallow food in your mouth.
  • Drink plenty of liquids: If you do not have fluid restrictions try and drink 6-8 cups of liquids a day. Keep a water bottle or travel mug close and try to take little sips as often as possible throughout the day.
  • Try thicker liquids: You may need to try thicker drinks like smoothies or milkshakes.
  • Sit up straight: You may have to eat or drink sitting upright or with your head turned one way or looking straight ahead. 
  • Take care of distractions: Ask people not to ask you questions or distract you when you are eating. Turn off the TV, radio and don’t use your cell phone while eating. 
  • Avoid: Any foods that make your swallowing problem worse. 
  • Limit or stop: Alcohol, caffeine and nicotine to see if your symptoms get better. These can cause dry mouth. 

Mental activities you can try:

  • Think positively: Positive thinking may ease swallowing difficulties.
  • Distract yourself: Do something that you enjoy to try and keep yourself mentally busy. For example, crossword puzzles, Sudoku, needlework or video games.
  • Relax: Try meditation, mindfulness, or relaxation therapy. Learning to relax and to change the way you think may help you cope with difficulty swallowing.

Relaxation techniques you can try at home. 
Ask if someone on your healthcare team can help you get started. You can also learn some on your own. Some techniques include: 

  • Progressive muscle relaxation: Focus on slowly tensing and then relaxing each muscle group.
  • Deep breathing exercises: Slow your breathing to the point where you are as relaxed in your breathing as possible. Breaths should be deep and fill your lungs. 
  • Meditation: Sit or lie in a comfortable position for 20 minutes. Be aware of your breathing, your sensations (including your difficulty swallowing), your thoughts and feelings. 
  • Guided Imagery: Form mental images to take a visual journey to a peaceful, calming place or situation. 
  • Yoga: Can relax your breathing, ease muscle tension, and energize your mind and body.
  • Massage: Helps reduce all over muscle tension and pain, which can help you relax.
  • Hydrotherapy: Uses flowing water to relax muscles.
  • Music and art therapy: Listening, playing music, drawing and painting can help you to relax.

Speak with your healthcare team if dysphagia is a problem for you. Your worries and questions are important to you and them. Your healthcare team may speak to you about the different medicines you can take.   

  • Let them know if you think your medical condition or medications are the reason for your swallowing difficulties.
  • Let your healthcare team know if a medication is working for you or if you’re having side effects. You may have to try a few different ones to know what works best for you.
  • Talk to them before taking over-the-counter medication, including vitamins and herbal remedies.

Tips on sharing your symptoms with your healthcare team:

  • Make some notes about your difficulty swallowing symptoms and tell your healthcare team about them.
  • Has there been a change in your swallowing difficulties?
  • What does your swallowing difficulties feel like? How bad is it?
  • When does it happen and how long does it last?
  • What makes it better or worse? What have you tried already?
  • Make a list of all the medications you are taking including over the counter medications.