Swallowing Difficulties Symptoms

Signs which could indicate potential swallowing difficulties include^1,2:

• History of choking
• Recurrent chest infections (due to food or liquid entering the respiratory tract)
• Coughing before, during or after swallowing
• Changing of breathing pattern of shortness of breath when eating/drinking
• 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
• Prolonged meal times
• Refusal to eat or drink
• Dehydration
• Patient complains of a feeling of “obstruction” when swallowing
• Patient has a dry mouth (xerostomia)

 

 

Some patients might not acknowledge their symptoms, perhaps through embarrassment or because of difficulties in communication, for instance following a stroke. Asking 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

Guidelines for healthcare professionals state that you should always ask a patient about swallowing difficulties before prescribing a medicine and assess the reasons for this. This should be taken into consideration when prescribing medication.³

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