Lesson Outline

Join Amanda and her father as they navigate the early signs of dysphagia and find ways to keep meals safe and enjoyable.

 20 minutes

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⏱ 3 min read

Common red flags of dysphagia

• Wet or gurgly-sounding voice immediately after swallowing
• Taking a long time to chew or swallow
• Coughing, throat clearing, or choking during or after swallowing
• The need for smaller bites or sips

Complications of swallowing problems

There are medical/physical and emotional/social consequences associated with dysphagia.

Medical/physical consequences

Medical or physical consequences include aspiration, when food, liquid, and/or medication goes down the “wrong pipe” into the airway instead of the stomach. This can cause coughing, choking, or even lead to a bacterial lung infection called aspiration pneumonia. Sometimes aspiration happens silently, without coughing. If silent aspiration goes on for a prolonged period of time, a person may start to look or feel tired, short of breath, uncomfortable during or after meals, or run a fever at the onset of an infection.

When food, liquid, and/or medication gets left behind in the throat after swallowing, it leaves a post-swallow residue that can later slip into the airway or even make swallowing uncomfortable.

When someone has trouble swallowing, they might avoid eating or drinking as much as they need. Over time, this can lead to:

• malnutrition (not getting enough nutrients)
• dehydration (from reduced fluid intake)
• sarcopenia (loss of muscle)

These problems can make a person feel weak, tired, and more at risk for other health issues.

If swallowing is difficult or painful, people might eat less, leading to noticeable and unhealthy weight loss.

Emotional/social consequences

Some of the emotional and social consequences of dysphagia include:

• fear
• frustration
• lack of enjoyment while eating
• anxiety
• depression
• social isolation

Some people feel pain when swallowing, making meals uncomfortable or even scary, resulting in both physical and emotional consequences.

What can you do?

If you or a loved one is experiencing swallowing problems, seek a referral to a speech-language pathologist who can assess and treat dysphagia by providing strategies to make swallowing easier and safer. Other professionals, such as occupational therapists and dietitians, can provide support for eating independently and ensuring adequate nutrition.

Staying safe

Download a handout from McMaster’s Aging Swallow Research Lab to get actionable tips for avoiding complications due to dysphagia. These include:

• Take your time: Eat slowly, take small bites and sips, and don’t rush.
• Good oral care: Brush teeth, dentures, and tongue at least twice daily. Rinse the mouth after meals to clear food and reduce bacteria.
• Positioning: Keep head and neck in a comfortable, neutral position (avoid leaning back).
• Watch for signs: Frequent coughing, throat-clearing, or a wet/gurgly voice after eating may signal swallowing problems. Speak to a healthcare provider.
• Sit upright: Sit as upright as possible (in a chair or supported in bed) while eating and for at least 30 minutes after.
• One thing at a time: Avoid talking while chewing or swallowing, and reduce distractions (e.g., TV, talking).
• Food adjustments: Choose moist, easy-to-chew foods when possible, and take sips of liquid between bites.
• Stay alert: Only eat or drink when awake and alert; avoid eating if overly tired, drowsy, or distracted.
• Medication safety: Ask a pharmacist before crushing tablets. Enquire about smaller doses or liquid formulations. Don’t mix pills with thickened liquids, as it can reduce effectiveness. Mix medications with applesauce or yogurt if safe.

Where to get support

The Virtual Canadian Dysphagia Support Group is hosted by the Aging Swallow Research Lab at McMaster University. The group is intended for individuals with dysphagia and their caregivers.

The Ontario Caregiver Organization supports caregivers by providing one-point access to information, services and resources so they have what they need to be successful.

The National Foundation for Swallowing Disorders is a comprehensive resource for dysphagia education and patient support. 

Find an SLP will help locate a speech-language pathologist in your area so you can get started.

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