Swallowing Difficulties Symptoms

Signs which could indicate potential swallowing difficulties include:

• Difficulty or pain when chewing or swallowing
• Recurrent chest infections (due to food or liquid entering the respiratory tract)
• Coughing during or after swallowing
• A rattling or gurgling voice (after liquids in particular). The voice may sound hoarse or ‘wet’
• Difficulty controlling food or liquid while in the mouth
• Regurgitating food or liquid
• Aspiration of food or liquid
• Unexplained weight loss
• Dehydration
• Patient complains of a feeling of “obstruction” when swallowing
• Patient has a dry mouth (xerostomia)

Some patients might not acknowledge their symptoms, possibly through embarrassment or because of difficulties in communication, for instance following a stroke. So asking key open questions may be useful in helping to identify patients with swallowing difficulties such as:

• ‘Do you cough after drinking or eating?’
• ‘Do you feel that tablets / capsules stick in your throat or chest?’
• ‘How long does it take you to eat?’
• ‘Does your mouth feel particularly dry’

The carer could be asked whether the patient:

• Appears to have difficulty swallowing the tablet or capsule
• Misses taking medication because of swallowing difficulties
• Sometimes hides medication instead of taking it
• Needs to suck or chew tablets to make them easier to swallow