Coping with Swallowing Difficulties
As we go through daily life, swallowing is as common as breathing. We rarely give it a second thought as we swallow hundreds of times each day.
Swallowing difficulties can occur for reasons ranging from dehydration to illness. Most cases are short-lived. But sometimes you might need medical treatment or special home care. If you have trouble swallowing, it is important to be evaluated by your health care provider. In some cases, swallowing difficulties may be due to serious problems.
Why swallowing problems occur
In most cases, swallowing problems aren’t serious. Swallowing problems have many causes, such as dehydration, or not chewing long enough or taking bites of food that are too big. Other swallowing problems stem from gastroesophageal reflux disease (GERD). This happens when bile or stomach acid flows back into your esophagus, or food pipe. Many medications, such as nitrates, calcium channel blockers, aspirin, iron tablets, and vitamin C, can cause difficulty swallowing. Other causes include allergies and even the common cold.
In rare cases, swallowing problems are tied to a serious illness. For example, a stroke, Parkinson disease, or late-stage Alzheimer disease can make it hard to swallow and possibly lead to choking. Diabetes, thyroid disease, a tumor in the mouth or throat, or high blood pressure could be to blame. Problems with your vocal chords; insertion of a tracheotomy, or breathing, tube, or oral or throat surgery can affect the way you swallow. Narrowing of the esophagus, due to cancer, GERD, or other illness, can also cause swallowing difficulties.
Symptoms of swallowing problems
Be aware of these signs of swallowing difficulties:
Feeling of a lump in your throat
Sensation that food or liquid is stuck in your throat
Pain or tightness in your throat or chest
Weight loss or not getting the nutrition you need because of trouble swallowing
Choking or coughing caused by bits of food or drink that get caught in your throat
When to call the health care provider
Swallowing problems are rarely serious, so it can be difficult to know when to seek help. Contact your health care provider:
If the problem doesn’t clear up quickly
If swallowing problems cause you to choke, cough, or have trouble breathing
If you’re losing weight or having trouble eating
What you can do about swallowing problems
If your swallowing difficulties are not related to a more serious illness, you can take some simple steps at home to make eating and drinking more effort-free.
If your problems stem from GERD, try taking antacids to control your acid reflux symptoms. Prop up the head of your bed. Eat smaller meals, and avoid food for about 3 hours before going to sleep. Tobacco, alcohol, and caffeine are also linked to GERD. Eliminating them may help, too. Obesity and stress are connected to GERD, so exercise and stress-busting activities like yoga may cut down on your symptoms.
The way you eat and drink can cause swallowing problems. Take smaller bites and chew thoroughly. Eat more slowly to make swallowing easier.
A speech or occupational therapist can help you relearn how to swallow if your problem was caused by nervous system damage from a stroke. A specialist can also teach feeding techniques for eating difficulties caused by Alzheimer disease. These include a smaller spoon. Also adding a special thickener to liquids, especially water, can make it easier to drink beverages without choking.
If your swallowing problems come from another type of serious illness, such as cancer, you may need a comprehensive treatment plan with medication or possibly surgery.
- Fetterman, Anne, RN, BSN
- MMI board-certified, academically affiliated clinician