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Difficulty swallowing

Difficulty swallowing is called dysphagia. There are a number of factors that can affect the ability to swallow. It may be as simple as a sore throat from a cough or cold. It can be due to acid reflux, where acid washes back up from your stomach and irritates your throat. Nerve conditions can also alter your swallow. Stroke, multiple sclerosis, Sjogren's syndrome, dementia and respiratory illnesses like COPD (chronic obstructive pulmonary disease) can all influence swallowing ability. Head, neck and upper oesophageal cancer can also cause swallowing difficulties. Anxiety and panic attacks may also make it difficult to swallow.

"Swallowing is a highly complex process which requires suitable posture and a co-ordinated head, neck, lip and tongue movement, along with a swallowing reflex," says Michelle McGuinness, a registered dietitian and British Dietetic Association spokesperson.

"If someone is experiencing difficulty with swallowing it can seriously compromise their food and fluid intake," adds Michelle. "It may also make them anxious and reluctant to drink and eat, which can have several secondary health effects."

It can be really frightening if you're having problems swallowing. It may feel like you are choking and you can't catch your breath. "It's not only scary it can be life-threatening," says consultant in oral medicine Dr Anwar Tappuni.

Seek medical advice

If it's happened a few times don't ignore, seek medical advice. The doctor will examine and assess you and may refer you to a specialist. Depending on what your GP thinks is the issue the referral may be to a neurologist, a speech and language therapist, a gastroenterologist or an ear, nose and throat (ENT) expert.

There are a number of tests they may carry out, including a swallowing assessment. You may be offered a test using an endoscope which is a tiny camera on a thin, flexible tube. It may be used to look into your stomach, oesophagus or nose.

A specialist speech therapist who deals with swallowing problems may assess you and teach you strategies to help.

They can help people to swallow again through modified head moves, positioning and individual exercises. They may recommend changes to the consistency of food, fluids and medication to reduce the risks of choking or malnutrition.

Dr Liz Boaden, a speech and language therapist says: "Therapeutic positioning, modified head postures and compensatory swallow strategies affect the way the food, fluid or medication moves from the spoon to the mouth, through the throat and oesophagus (food pipe) into the stomach. Direct long term rehabilitation exercises aim to directly improve the specific muscle function necessary for a safe swallow." 

Swallowing problems can have a negative effect on how people live their lives especially as eating and drinking play a big part in many social occasions.

"People with swallowing difficulties report social and psychological issues and reduced quality of life owing to embarrassment, anxiety and fear of choking in public. This makes people withdraw from social settings and become more isolated," says Dr Boaden.

Seeing a dietitian may help you overcome or reduce the problems you are having, and will make sure whatever texture of food or drinks is needed, that your diet is well balanced for your needs.

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