Swallowing Problems

Difficulties with swallowing are known as "dysphagia". Dysphagia occurs when there is difficulty moving food or liquid safely from the mouth down into the stomach. Food or liquid may pass into the trachea (windpipe) and then into the lungs, instead of the stomach. This may cause obstruction of the airway, and may result in pneumonia. In some cases, food might move slowly or 'stick', or liquid may be regurgitated into the nose.

Swallowing difficulties may occur at any age, for a variety of reasons (see below).

Characteristics

There are a number of signs that may indicate or suggest a swallowing difficulty. These include:

• coughing or choking when eating or drinking
• unexplained coughing or choking after meals
• a "gurgly" sounding voice after eating or drinking
• a feeling of food "stuck in the throat" after swallowing
• difficulty chewing and controlling food in the mouth
• taking a long time to finish a meal
• needing to swallow several times to clear each mouthful of food
• excessive drooling, especially immediately after meals

Other signs that may be noticed after a period of time may include:

• repeated chest infections
• unexplained weight loss
• loss of appetite
• fear of eating

Causes

There are a number of causes of dysphagia, which include:

• neurological disorder which affects the control of the muscles of swallowing (e.g. stroke, Motor Neurone Disease, Parkinsons Disease, or Multiple Sclerosis)
• disease or injury that affects the swallowing structures (e.g. cancer of the tongue)
• surgery to the head, neck, or oesophagus (food tube)
• injury to the head, neck, throat, or oesophagus
• presence of a tracheostomy tube

Role of the Speech-Language Therapist

Following a referral, the Speech-Language Therapist will assess an individual's swallow, and make recommendations around diet texture, bite size (mouthful size), feeding utensil, and optimal posture. The Speech-Language Therapist will then monitor progress.

The Speech-Language Therapist will liaise with the individual, family/carers, and members of the swallowing team, and will make appropriate referrals (e.g. dietician or neurologist).

What you can do

If you, or someone you know, has difficulty swallowing, seek professional advice from your local doctor or hospital. There are many reasons why swallowing difficulties may exist, and it is important to investigate underlying causes as soon as possible.

Avoid any food or liquid that is difficult to swallow, until you see a Speech-Language Therapist.

Ask your nurse, or doctor to teach you how to safely use the "Heimlich manoeuvre".

More Information

For more information about dysphagia, or to contact a Speech-Language Therapist, please consult:

• your doctor
• your local hospital
• the Yellow Pages
• Massey University Speech-Language Therapy Clinic: (09) 414 0800 ext 41290 / 41277
• the University of Auckland Speech-Language Therapy Clinics: (09) 303 5979
• the University of Canterbury Speech and Hearing Clinic: (03) 364 2408
• the NZSTA Private Practice Register