Speech and Language Therapists can help you with eating, drinking and swallowing difficulties because of their knowledge of the structure, muscles and nerves used in swallowing.
Speech and language therapists assess the safety and efficiency of your swallow. They can give advice on how to manage eating, drinking and swallowing difficulties.
Speech and Language Therapists may recommend:
- Exercises to improve the strength and movement of the muscles needed for swallowing
- Changing positioning when eating and drinking
- Strategies (such as slower pace, smaller mouthfuls) and assistance
- Education on oral hygiene and mouth care
- Trying different types of food and drink
Associated conditions
Swallowing difficulties (dysphagia) in adults is associated with a number of different conditions, including:
- Stroke
- Progressive neurological disorders, including dementia, Parkinson’s disease, motor neurone disease, multiple sclerosis, and muscular dystrophy
- Cancer, including head and neck, lung, and oesophageal
- Respiratory conditions, including chronic obstructive pulmonary disease, emphysema, and asthma
- Learning disability, developmental and acquired disorders
- Disorders of the immune system
- Traumatic brain injury
- Acutely ill patients in hospital
- Frailty in older people
- Guillain-Barré and influenza
- Acid reflux
Swallowing problems can be mild or severe, last for a short time or persist for a long time. Some swallowing problems may change over time.
Signs of a swallowing problem
Common signs of a swallowing problem are:
- food sticking in, or falling out of, your mouth
- taking a long time to eat or drink
- difficulty getting food over
- food or drink sticking in your throat
- your voice sounding wet or gurgly when eating or drinking
- coughing or choking
Choking on a lump of food may interfere with breathing and need emergency help by calling 999. Smaller quantities of food or drink can go down the wrong way into the gullet, known as aspiration and can cause a chest infection or aspiration pneumonia.
Eating and drinking safely
Please be aware that not all these items will apply to you, and always seek advice from a speech and language therapist.
Safer eating and drinking tips
- Sit in an upright position.
- Take your time.
- Try to eat in a quiet place with few distractions.
- Soft, moist foods may be easier – it may help if you choose foods that require little or no chewing.
- Chew food well and make sure your mouth is empty before taking another mouthful.
- Only heat up small portions of food at a time so the food does not get cold.
- Smaller, more frequent foods may be less tiring.
- It may help to have your medicines in a liquid or soluble form – speak to your GP or pharmacist.
High risk foods
Certain foods are more likely to make you cough and choke and therefore you should avoid them.
Foods with a high choking risk
- Stringy, fibrous textures, such as pineapple, runner beans or celery.
- Vegetable and fruit skins including peas, grapes, baked beans, soya beans, and black-eyed beans.
- Mixed consistencies – such as cereals and milk, meat and thin gravy or soup with lumps.
- Crunchy foods such as toast, dry biscuits or crisps.
- Crumbly items such as bread crusts, pie crusts or dry biscuits.
If you have swallowing difficulties and are on Oral Nutritional Supplements (ONS), please follow the directions from your dietitian and/or speech and language therapist.
Resources
- Royal College of Speech and Language Therapists (RCSLT) offers advice on how speech and language therapy can support you.
- Alzheimer’s Society has information on eating and drinking difficulties in people with dementia.
- Guy’s and St Thomas’ NHS Foundation Trust has further advice on dysphagia and swallowing problems.
Speech and Language Therapists can also support with eating and drinking difficulties in individuals with learning disabilities.