• Reference Number: HEY1486/2024
• Departments: Speech and Language
• Last Updated: 31 May 2024

Introduction

This leaflet has been produced to give you general information about swallowing problems.  Most of your questions should be answered by this leaflet.  It is not intended to replace the discussion between you and your Speech and Language Therapist (SLT) but may act as a starting point for discussion.   If after reading this you have any concerns or require further explanation, please discuss this with your SLT.

What is dysphagia?

Dysphagia is the medical term given to describe difficulty in swallowing.

The normal swallow

Swallowing is a complex process involving the coordination of many nerves and muscles of the mouth, throat and oesophagus (food pipe).

What happens when we eat/ drink?

• Food or drink is placed in the mouth
• The jaw and lips close to keep food or drink in the mouth
• Food is then chewed to form a ball and moved to the back of the mouth using the lips, tongue and jaw
• The throat muscles squeeze the food downwards and the swallow reflex is triggered
• There are two tubes in the throat; the trachea (windpipe) which goes down to the lungs, and the oesophagus (food pipe) which goes down to the stomach
• When we swallow, the voice box, which sits on top of the windpipe, rises to shut off the airway and lungs. This stops food or drinks going down the windpipe and into the lungs
• The oesophagus opens to allow food and drink to go down to the stomach

Swallowing problems

If the muscles used for swallowing are not working properly, one or more of the following may occur:

• Difficulty keeping food or liquids in the mouth
• Difficulty biting or chewing
• Difficulty moving and controlling food and liquids in the mouth
• Difficulty moving food to the back of the mouth
• Bits of food getting left in the mouth
• Food or liquids getting stuck in the throat
• Food or liquid going into the windpipe (aspiration) causing coughing, choking, chest infections and pneumonia

Swallowing problems and their progression vary greatly depending on the cause.  Please ask your SLT any questions you have about your swallowing.

How are swallowing problems managed?

The SLT can assess and manage swallowing difficulties.  He or she may advise:

• Swallowing exercises
• Safe swallowing techniques or postures
• A modified diet such as puree or soft foods. These consistencies are easier to chew and move around the mouth.
• Thickened drinks which travel more slowly and allow your muscles extra time to close the entrance to the windpipe.
• Help with your feeding from a carer.
• If the swallowing problem is severe and food or drinks are likely to go into the lungs, you may be advised not to eat or drink at all. In this instance you would need to be referred to a dietitian.
• Referral to a dietitian if your overall food intake is poor, you have reduced appetite or weight loss.

The SLT will monitor your swallowing and provide advice on any changes.

General advice

• When eating and drinking, always sit as upright as possible
• Eat slowly, one mouthful at a time. Make sure that each mouthful is swallowed before taking the next one.
• With drinks, take small sips
• Avoid mixing drinks and food in the same mouthful
• Do not throw your head back whilst eating/ drinking
• Avoid talking whilst eating and drinking
• Sit upright for at least 30 minutes after eating and drinking
• Ensure good oral hygiene. The mouth should be clear of all food after meals.
• Ensure dentures fit properly
• Your SLT may have given you specific swallowing advice. Please follow this advice carefully.

Should you require any further advice on the issues contained in this leaflet, please contact the Speech and Language Therapy Department on telephone number: tel: 01482 626700 or tel: 01482 875875

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.