Treatment for Swallowing Disorders
Being able to swallow saliva, food, and liquids is something many of us take for granted. Swallowing happens constantly throughout the day and is essential for nutrition, hydration, and overall health. What may seem like a simple action is actually a complex process involving coordinated muscles, nerves, the mouth, throat, and nervous system.
Problems occur when something interferes with the swallowing process. A swallowing disorder can affect a person’s ability to eat, drink, take medication, or swallow safely. Because swallowing problems can sometimes lead to serious health issues, persistent or sudden difficulty swallowing should be assessed by an appropriate healthcare professional.
At S.L. Hunter SpeechWorks, Speech-Language Pathologists assess and provide swallowing therapy for a variety of swallowing disorders across different age groups.
What Is Dysphagia?
The medical term for difficulty swallowing is dysphagia. A person with dysphagia may experience difficulty moving food or liquid safely and efficiently from the mouth through the throat and toward the stomach.
Signs of swallowing difficulties may include:
- Coughing or choking while eating or drinking
- Feeling that food is stuck in your throat
- Difficulty chewing food
- Taking significantly longer to eat
- A wet or gurgly voice after swallowing
- Food remaining in the mouth after swallowing
- Difficulty managing saliva
- Avoiding certain foods because they are difficult to swallow
- Unexplained weight loss
- Repeated respiratory infections
- Trouble breathing during or after eating
- Difficulty swallowing pills
- Needing several attempts to swallow food or liquid
Some people may experience swallowing issues without obvious coughing or choking, making professional assessment particularly important when concerns persist.
Types of Swallowing Disorders
Swallowing disorders can be categorized according to the part of the swallowing process that is affected.
Oral Dysphagia
Oral dysphagia involves difficulty preparing or moving food through the mouth. A person may experience problems with chewing, controlling food or liquid, or moving material toward the back of the mouth to begin the swallow.
Oropharyngeal Dysphagia
Oropharyngeal dysphagia affects movement of food or liquid from the mouth through the throat. Difficulties may involve the tongue, throat muscles, airway protection, muscle strength, coordination, or neurological control of swallowing.
This is an important area of practice for Speech-Language Pathologists.
Esophageal Dysphagia
Esophageal dysphagia occurs when food has difficulty moving through the esophagus, the passage that carries food toward the stomach.
Possible causes can include narrowing, scar tissue, abnormal muscle contractions, or conditions associated with acid reflux and gastroesophageal reflux disease (GERD). Esophageal swallowing problems often require assessment and medical treatment from a physician or gastroenterology specialist rather than treatment by a Speech-Language Pathologist alone.
What Causes Swallowing Difficulties?
There are many possible causes of swallowing disorders.
Neurological conditions are a common cause because swallowing relies on coordinated communication between the brain, nerves, and muscles. Dysphagia may occur following or alongside:
- Stroke
- Brain injury
- Parkinson’s disease
- Amyotrophic lateral sclerosis (ALS)
- Cerebral palsy
- Multiple sclerosis
- Spinal cord or neurological injury
- Other conditions affecting the nervous system
Muscle disorders, muscle weakness, or reduced coordination can also interfere with swallowing.
Other causes may include:
- Head and neck cancer
- Head or neck surgery
- Structural changes involving the mouth or throat
- Certain medications
- Gastrointestinal conditions
- Scar tissue
- Other medical conditions affecting the swallowing system
The appropriate dysphagia treatment depends greatly on the underlying cause and which stage of swallowing is affected.
Why Swallowing Problems Should Be Assessed
When swallowing is impaired, food or liquid may enter the airway instead of travelling safely toward the stomach. This is called aspiration.
Aspiration can increase the risk of a lung infection known as aspiration pneumonia, although not every episode of aspiration results in pneumonia.
For this reason, persistent coughing, choking, difficulty swallowing, unexplained changes in eating habits, or other problems swallowing should not simply be ignored.
A person's swallowing abilities may also affect nutrition, hydration, independence, and enjoyment of eating.
Swallowing Assessment
Assessment begins with understanding the person’s medical history, symptoms, eating habits, and suspected cause of the swallowing difficulty.
A Speech-Language Pathologist may assess:
- Movement and coordination of the mouth and tongue
- Ability to chew food
- Swallow timing
- Voice quality before and after swallowing
- Coughing or choking
- Management of food and liquids
- Muscle strength and coordination
- Strategies that may make swallowing easier
Clinical assessment may sometimes be supplemented by an instrumental swallowing assessment.
Modified Barium Swallow
A modified barium swallow, also known as a videofluoroscopic swallowing study, uses moving X-ray images to examine what happens as a person swallows different food and liquid consistencies.
It can help identify where swallowing problems occur and whether material enters the airway.
Endoscopic Evaluation of Swallowing
A Flexible Endoscopic Evaluation of Swallowing (FEES) uses a small flexible endoscope passed through the nose to view structures in the throat before and after swallowing.
These assessments can provide additional information that helps guide appropriate treatment and recommendations.
Treatment for Swallowing Disorders
Treatment for swallowing disorders is individualized according to the type and severity of dysphagia, the person's medical condition, and the underlying cause.
A Speech-Language Pathologist may recommend:
- Swallowing exercises
- Strategies to improve swallowing safety or efficiency
- Changes in posture or positioning
- Techniques such as an effortful or “swallow hard” strategy when clinically appropriate
- Changes to bite or sip size
- Slower pacing during eating
- Adjustments to food or liquid consistency when indicated
- Education for family members and caregivers
Some individuals may find softer foods easier to manage, while others may require different dietary changes. These recommendations should be made based on individual assessment rather than assuming one diet is appropriate for everyone.
The purpose of swallowing therapy may include improving swallowing function, maintaining muscle strength, compensating for difficulty, and helping the individual eat and drink as safely and comfortably as possible.
When Additional Medical Treatment Is Needed
Not every swallowing disorder can be treated through speech-language pathology alone.
Depending on the underlying cause, treatment may involve physicians, dietitians, gastroenterologists, neurologists, surgeons, or other healthcare professionals.
Some people with severe dysphagia may temporarily or permanently require tube feeding or a feeding tube to support nutrition and hydration. Decisions about feeding tubes are medical decisions made collaboratively based on the individual's overall health and swallowing abilities.
Conditions affecting the esophagus may also require medications, other procedures, or medical treatment.
Swallowing Therapy at S.L. Hunter SpeechWorks
At S.L. Hunter SpeechWorks, our Speech-Language Pathologists assess and treat swallowing difficulties associated with neurological conditions, brain injury, aging, and other health conditions.
Treatment is based on the individual’s specific swallowing problems, medical history, assessment findings, and personal needs.
If you or someone you care for is experiencing trouble swallowing, choking, difficulty eating or drinking, or other swallowing problems, contact S.L. Hunter SpeechWorks to learn more about swallowing assessment, dysphagia treatment, swallowing exercises, and treatment for swallowing disorders.