Swallowing problems
Dysphagia
General tips to help with swallowing problems. Sit up as straight as possible when you eat. Take small bites, less than 1 teaspoon (5 grams) of food per bite. Chew well and swallow your food before taking another bite. If one side of your face or mouth is weaker, chew food on the stronger side of your mouth. DO NOT mix solid foods with liquids in the same bite. Keep mealtime relaxed. DO NOT try to wash down solids with sips of liquids, unless your therapist told you to eat this way. Sit upright for 30 to 45 minutes after eating. You may need someone to remind you to finish swallowing. DO NOT drink thin liquids without checking with your doctor or therapist first. Ask caregivers and family members not to talk to you when you are eating or drinking.
What to Expect at Home
Symptoms of swallowing problems include:
- Coughing or choking, either during or after eating
- Gurgling sounds from the throat, during or after eating
- Throat clearing after drinking or swallowing
- Slow chewing or eating
- Coughing food back up after eating
- Hiccups after swallowing
- Chest discomfort during or after swallowing
- Unexplained weight loss
Symptoms may be mild or severe.
Home Care
Most people with dysphagia should be checked by a health care provider if the symptoms persist or come back. But these general tips may help.
- Keep mealtime relaxed.
- Sit up as straight as possible when you eat.
- Take small bites, less than 1 teaspoon (5 mL) of food per bite.
- Chew well and swallow your food before taking another bite.
- If one side of your face or mouth is weaker, chew food on the stronger side of your mouth.
- Do not mix solid foods with liquids in the same bite.
- Do not try to wash down solids with sips of liquids, unless your speech or swallowing therapist says this is OK.
- Do not talk and swallow at the same time.
- Sit upright for 30 to 45 minutes after eating.
- Do not drink thin liquids without checking with your doctor or therapist first.
You may need someone to remind you to finish swallowing. It may also help to ask caregivers and family members not to talk to you when you are eating or drinking.
When to Call the Doctor
Call your provider if:
- You cough or have fever or shortness of breath
- You are losing weight
- Your swallowing problems are getting worse
References
Ambrosi D, Lee YT. Rehabilitation of swallowing disorders. In: Cifu DX, ed. Braddom's Physical Medicine & Rehabilitation. 6th ed. Philadelphia, PA: Elsevier; 2021:chap 3.
DeVault KR. Symptoms of esophageal disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 13.
Emmett SD. Otolaryngology in the elderly. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 13.
Version Info
Last reviewed on: 5/6/2022
Reviewed by: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
