How do I know that I or my loved one may need a swallowing evaluation?
- Swallowing is painful or uncomfortable
- Difficulty chewing
- Difficulty moving food around in the mouth. (The tongue gathers the food into a ball. The tongue even holds liquid in a ball-like shape. The tongue helps control food and liquid as it moves the ball upward and backward, towards the back of the mouth.)
- Food falling out of your mouth or into the back of your throat before you are ready to swallow.
- Taking a long time to chew a single mouthful of food.
- Requiring many swallows to get food and liquid to go down your throat.
- Requiring liquids to wash food out of mouth or through your throat.
- Tiring easily before you are able to finish your meal.
- Eating slower and eating less.
- Unexplained weight loss.
- Frequent throat clearing, coughing, and/or choking during or shortly after eating, drinking, or taking medications.
- Increased congestion or shortness of breath during or after eating or drinking.
- Voice sounding wet and gurgly during or shortly after eating or drinking.
- Coughing on saliva or voice sounding wet throughout the day due to saliva pooling in the throat. Drooling saliva.
- Feeling food or pills stuck in the throat. Sometimes people describe food and/or pills getting stuck up high in the throat where they can be coughed back up. Other times it feels like a ball in the throat that does not clear. See if you can point to where you feel it. Testing can help you know if it is stuck in the throat or in the esophagus (the food tube to your stomach).
- Repetitive respiratory infections (e.g., pneumonia).
What should I do?
TALK WITH YOUR DOCTOR and describe the feelings and symptoms as best as you can. He/she can give you a doctor’s order (prescription) to see a swallowing specialist (a Speech-Language Pathologist who specializes in swallowing and swallowing disorders). Read more about how your swallowing can be tested.
If left untreated, a swallowing problem could lead to:
- Dehydration (by not taking in enough fluids),
- Weight loss and malnutrition (by not getting in enough calories and essential nutrients), and
- Aspiration pneumonia (a lung infection from bacteria getting into your lungs with the food, liquid, saliva, and/or regurgitated/refluxed material).
Aspiration is when material is inhaled, falls into the airway, or is misdirected into the airway due to inadequate airway protection. Once the material drops below the vocal folds (in your voice box/larynx, commonly referred to as the adam’s apple), that is an aspiration. If it is not immediately detected and coughed out, it will fall into the lungs. Sometimes material can get into the airway and not be detected by the person, and this is referred to as “silent aspiration.”
Seeing a Speech-Language Pathologist can help you and your doctor figure out what type of test(s) would be the best and most efficient way to fully evaluate your problem.
By Karen Sheffler