So You're Having Trouble Swallowing....

Did you know that adults swallow approximately 600 times a day!

Eating and drinking is something we naturally do, at least 3 times a day and are often opportunities to connect with people, whether it be family around a dinner table at home, friends at a restaurant, or coworkers at a bar. When someone has trouble eating or drinking, they often skip these kinds of activities so they don’t feel embarrassed.

I’m here to share some general swallowing strategies and recommendations that may help. If you are having trouble swallowing, be sure to consult with your family physician first!

You might have dysphagia, or trouble swallowing, if…..

• You cough frequently during or after swallowing foods/drinks

• Things get “stuck in your throat”

• Food/drinks “go down the wrong pipe”

• Trouble swallowing pills

• Still have food left in your mouth after you swallow

• Experience significant, unplanned weight loss

• Choking episodes

• You don’t enjoy eating/drinking anymore or you’re embarrassed to eat/drink around others.

How does swallowing work?

Let’s use an apple as our example. You take a bite of the apple with your teeth, and then continue to grind the apple into tiny pieces, while it mixes with saliva in your mouth. When you’re ready to swallow, your tongue pushes the apple to the back of your throat. When you swallow, the roof of your mouth raises to close off the nasal cavity, so that the apple does not come out your nose. At the same time, epiglottis closes over top of your windpipe and vocal cords (the larynx) to keep the apple from going into your lungs. At that point the apple is pushed into the esophagus.

What can a speech therapist do?

A speech therapist will begin with a basic clinical swallow evaluation, which will ask various questions about your swallowing, look at how your lips, tongue, and jaw move, and provide various trials of food and drinks. A speech therapist will often recommend a video swallow study to further look at the swallow function. Based on the deficits that are noted in the bedside swallow study and video swallow study, the SLP will make recommendations regarding diet, swallow strategies, and specific exercises.

General Swallowing Recommendations:

Strategies:

• Eat/drink slowly: Try putting your silverware down between bites. Same thing with your drinks, take one at a time, and put the cup down between sips.

• Take small bites and sips: Fill only half your utensil, cut meat into pieces the size of a quarter.

• Alternate foods and drinks: Take a couple bites of food, then take a sip of your drink to help clear any food that may be lingering in your mouth or throat.

• Swallow a second time after initial swallow of food: Helps clear any food that may be lingering in the throat.

• Eat smaller meals, more often: Helps prevent the muscles from becoming too tired to work properly.

• Sit upright while eating/drinking and remain upright for a minimum of 30 minutes: This ensures that the food/drinks make it all the way to the stomach and help prevent reflux.

• Do not talk while eating/drinking: Wait until you have completely swallowed everything prior to attempting to speak.

• Reduce distractions around you while eating, such as turning off the TV or radio, this helps you focus on eating and the strategies listed above.

Food Modifications:

• Add extra sauces or gravy to your meals

• Cut food into bite sized pieces

• Grind food in a food processor or puree in a blender

• Focus on eating softer foods such as cooked vegetables, softer/ground meats like meat loaf, and softer fruits in juice or cut off of the rind.

• Avoid skins on fruits and vegetables

Swallowing Pills in the most commonly-reported problem for people living with dysphagia.

Pill Modifications:

• Ask the pharmacist and doctor about a different form of the pill (i.e. liquid, tablet, capsule, etc.)

• Ask the pharmacist or doctor about breaking the pills or crushing them.

• Take with pudding or applesauce

• Take one pill at a time

• Start with the smaller pills and work your way up to the bigger ones

Oral Care

• Oral care is key in preventing pneumonia from food, liquids, or bacteria that enter the lungs.

• After meals, clear any food that may be remaining in the mouth with a drink of water or your tongue.

• Using a toothbrush and toothpaste to brush all surfaces of the teeth, gums, and tongue for at least two minutes.

• Use a mouthwash, if able to swish and spit.

• If you have dentures, take them out and clean them with a toothbrush. Leave them out of your mouth overnight in a cup of water to soak with a denture cleaner.

I know this is a lot of information, but if you or a loved one are experiencing some of the symptoms above, or you have questions about what you learned from reading the above, reach out to us! https://www.lifespeechservices.org/contact-us

Resource Recommendation

"So You're Having Trouble Swallowing.... A Guide to Assessment and Treatment Options for Patients with Swallowing Difficulties" by Theresa Richard M.A. CCC-SLP, BCS-S

https://www.amazon.com/So-Youre-Having-Trouble-Swallowing/dp/B09CGFWRQN