Treatment for dysphagia is available, so if you do find swallowing difficult it is extremely important that you ask your Primary Healthcare Professional for help. The problem will not usually be cured, but there are so many ways to make eating and drinking easier, that you should not hesitate to seek professional advice.

People who find it hard to swallow need help for two important reasons.

• Firstly, so that they do not become dehydrated or malnourished.



• Secondly, to reduce the chance of food and drink ‘going down the wrong way’ and ending up in the airways and lungs, which can lead to pneumonia.

Before treatment can begin it is important that an accurate diagnosis of your difficulty is made because treatment will depend on which of the four stages of the normal swallow is affected.

Treatment falls into four different categories:

• Surgery/switching medical prescription



• Physical modification



• Swallow modification



• Food modification

How successful the treatment is will depend to a certain extent on you. The more you understand what is going on and take an active role in your treatment, the more encouraged you will feel, the more confidence you will gain, and the more satisfied you will become.

Surgery/switching medical prescription

• Occasionally, the problem can be helped by surgery, but for the majority of people this is not possible.



• Sometimes dysphagia is triggered by a medication prescribed for another condition: some drugs to control epilepsy and insomnia for example, can make swallowing hard, so it is worth checking with your GP to see if these may be the cause of your problem.

Physical modification

• Always sit up as straight as possiblewith your shoulders level.



• If food gets stuck – for even a short time – stand up, stretch the top half of your body and walk around, it may help the food slip down into your stomach – never lie down.



• If the muscles in your jaw and tongue are weak you can be taught exercises to strengthen them so that chewing becomes more effective.
• Learn to take deep long breaths (speech therapists can teach people how to breathe more effectively as well as help people strengthen the muscles in their tongue and larynx).



• If you have false teeth, make sure they are fitting properly.



• Do not eat less than three hours before you go to bed. If food gets stuck in your oesophagus overnight it can be very uncomfortable and sometimes painful.

Swallow modification

• Cut up your food into small mouthfuls or ask someone to do this for you.



• If you have lost your sense of smell and taste you will not always produce enough saliva to soften your food. Make sure that your food looks as appetising as possible and that your meals have plenty of colour.



• Have plenty of drinks to hand to help food to pass.



• Make sure you have plenty of time to eat and you are not rushed.



• Try to eat in peace and quiet, without stress and without other people standing over and watching you.

Food modification

If your problem is in the lower part of your oesophagus you may find it impossible to eat any solid food at all. In this case you will need to modify your food and change the texture so that it can be swallowed safely.

• Liquids need to be thickened: you might think that water and liquids are easier to swallow, but when you have little control over the flow, it is all too easy for them to pass into your airways and lungs. Thickening agents are available to you on prescription through your Primary Healthcare Practitioner or a Dietitian.



• Food that is a bit sour, served with lemon, for example can trigger the swallowing reflex automatically.



• Food needs to look good to stimulate appetite. Puree meat and vegetables separately so they do not look unappetising. Use deep-coloured vegetables – broccoli and spinach, for example.



• Solid foods need to be pureed or softened, so they need less chewing and require less propulsive force to clear them through the pharynx.