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We all have problems swallowing once in a while. We may have trouble chewing a tough piece of chicken or difficulty swallowing a big bite. A drink can “go down the wrong way,” making us cough and choke. A person with a swallowing disorder will have trouble like this all the time. A swallowing disorder is also called dysphagia (dis-FAY-juh) - difficulty chewing and swallowing liquids and/or solids. 

Swallowing happens in three stages, or phases. You can have a problem in one or more of these phases. They include:

  • Oral phase – sucking, chewing, and moving food or liquid into the throat.
  • Pharyngeal phase – starting the swallow and squeezing food down the throat. You need to close off your airway to keep food or liquid out. Food going into the airway can cause coughing and choking.
  • Esophageal phase – opening and closing the esophagus, or the tube that goes from the mouth to the stomach. The esophagus squeezes food down to the stomach. Food can get stuck in the esophagus. Or, you may throw up a lot if there is a problem with your esophagus.


GENERAL SIGNS OF SWALLOWING DISORDERS:

  • coughing during or right after eating or drinking
  • wet or gurgly sounding voice during or after eating or drinking
  • extra effort or time needed to chew or swallow
  • food or liquid leaking from your mouth
  • food getting stuck in your mouth
  • having a hard time breathing after meals
  • losing weight


CONSEQUENCE OF SWALLOWING DISORDERS:

  • dehydration or poor nutrition
  • food or liquid going into the airway, called aspiration
  • pneumonia or other lung infections

  • you may feel embarrassed when eating. You may feel badly about your swallowing problems and want to eat alone.


CAUSES OF SWALLOWING DISORDERS:
There are many conditions that can cause swallowing problems. Sometimes general decline with age can cause problems. Some medications can cause dry mouth, which makes it hard to chew and swallow. Other causes include the following:

  • Damage to your brain or nerves from: stroke, brain tumour, traumatic brain injury, Parkinson's disease, multiple sclerosis,  amyotrophic lateral sclerosis (ALS, or Lou Gehrig's disease), muscular dystrophy, cerebral palsy, Alzheimer's disease.
  • Problems with your head or neck, such as: cancer in your mouth, throat, or esophagus, head or neck injuries, mouth or neck surgery, bad teeth, missing teeth, or dentures that do not fit well


TESTING FOR SWALLOWING DISORDERS:
An SLP can test you to see how you eat and drink, ask you about your health, past illnesses, surgeries, and your swallowing problems, see how well your mouth muscles move, watch you eat to see how you sit and feed yourself and what happens when you swallow, and do special tests, if needed. The SLP can watch how you swallow using instrumental tests (modified barium swallow, endoscopic assessment).

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TREATMENTS FOR SWALLOWING DISORDERS:
What treatment you need will depend on the problems you have. You may need medical treatment, such as medicines for reflux. In severe cases, you may need to get nutrition in other ways. These may include a tube through your nose or in your stomach. Your doctor will work with you if you need tube feeding. Your Connect S-LP can work with you to improve how you swallow by recommending various strategies or exercises to ensure a safer, better swallow, as well as, educate caregivers and family on ways to assist.


​Source: American Speech-Language-Hearing Association, Speech-Language & Audiology Canada, 2018

Swallowing