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Swallowing difficulties in movement disorders

Essential facts for patients

Can movement disorders affect swallowing?

Yes. If you have a movement disorder, it can affect your chewing and swallowing. When you decide to swallow, your brainstem takes over to make sure that the food arrives safely in your esophagus and stomach and not your windpipe. This process may be disrupted if you have a movement disorder, such as Parkinson’s disease. 

What are the common swallowing disorder symptoms?

The most common symptoms are:

• Food getting stuck in your throat.
• Difficulty swallowing pills.
• Food or liquid getting in your windpipe (aspiration), causing you to cough.

When do swallowing disorders happen?

For people with Parkinson’s disease, swallowing disorders often start in the middle or later stages of their disease. However, it can start much earlier with other types of movement disorders.

What are the consequences of swallowing disorders?

Swallowing disorders affect people differently. Some possible consequences include: 

• Coughing during eating and drinking. This may make dining with others less pleasant.
• Feeling meal-time anxiety.
• Giving up some favorite foods that are too tough to chew and swallow.
• Taking longer for meal times. While this may not be a problem for some, it can be a nuisance for others.
• Losing weight because you’re not eating enough.
• Running a risk for pneumonia when the coughing defense mechanism decreases.

How can I identify swallowing disorders?

Here are some signs that you may have a swallowing disorder:

• Your eating and drinking are taking a long time or becoming bothersome.
• You are starting to cough while eating (more than once a week).
• You have a decreased appetite and you’ve noticed gradual changes in your diet.
• You need to drink fluid more frequently when swallowing your food.

If you are seeing these signs, you should speak with your health care professional.

What can I do to make swallowing easier?

There are several things you can do to help make swallowing easier, depending on the problem:

• To prevent sudden aspiration of food or liquid, do not talk and eat (or drink) at the same time. If this is a challenge in your social environment, try talking to the people you are eating with to help them understand the difficulty you are having.
• If you find it hard to swallow pills, it may help to take them with a liquid that is thicker than water, like applesauce. Please note that you should avoid taking dairy products with your pills as the proteins may interfere with levodopa. 
• Choose softer foods to eat to make chewing and swallowing easier.
• If you tend to choke on the last sip from a cup, bend your head in a neutral or chin-down position before swallowing.

What can professional caregivers do to help?

Professional caregivers may help with your swallowing disorder in many ways. Speech-language pathologists, neurologists, dieticians, nurses and psychologists:

• Educate and advise you about foods or pills that are easier to swallow.
• Teach you exercises or maneuvers to help avoid aspiration or make your swallowing stronger.
• Provide you with exercises to improve your coughing strength.

If your swallowing disorder becomes severe, your professional caregivers may advise you on tube feeding to keep your food and liquid intake optimal.

In summary

• Problems with chewing and swallowing food or pills are common with movement disorders.
• People with swallowing disorders may experience coughing during eating and drinking and/or difficulty with getting food down. 
• Swallowing disorders often mean longer meals, limitations on what you can eat, or even pneumonia.
• Report your swallowing complaints to your health care team. Education, support and treatment are available.

 

Copyright © 2020 International Parkinson and Movement Disorder Society (MDS).  All rights reserved.