Home / Medicine Management For Health Professionals / Patients Most Vulnerable To Swallowing Difficulties /

Patients Most Vulnerable To Swallowing Difficulties

A number of diseases which tend to become more common with advancing age influence the likelihood of developing swallowing difficulties, including:

  • Malignant or benign tumours – particularly of the neck or upper gastrointestinal tract
  • Stroke - in the early stages of a stroke or TIA nearly 80% of patients will have some sort of swallowing problem or dysphagia [3]
  • Alzheimer’s, Parkinson’s and Motor Neurone disease - almost half of Parkinson’s disease patients show some degree of dysphagia [4]
  • Chronic Type 2 diabetes – oesophageal motility declines as the duration of  diabetes mellitus increases [5]

Medication side effects can contribute to swallowing difficulties by influencing gastrointestinal motility including:

  • Some antidepressants
  • Some agents with anticholinergic actions
  • Opioids
  • Calcium antagonists

Patients prescribed the following drugs are likely to be more prone to xerostomia (dry mouth due to a lack of saliva) [2]:

  • Certain beta-blockers e.g. carvedilol
  • Some diuretics e.g. amiloride, triamterene
  • Tricyclic antidepressants e.g. amitriptyline, dosulepin
  • Other antidepressants e.g. fluoxetine
  • Antihistamines e.g. chlorphenamine, promethazine
  • Certain antipsychotics e.g. chlorpromazine, haloperidol
  • Antimuscarinic drugs e.g. hyoscine, ipratropium

A study of 600 older people found that 33% took at least one medication that could induce xerostomia [6], which is often linked to swallowing difficulties.