Swallowing Difficulties Symptoms

Learn about signs which could indicate potential patient swallowing difficulties.

Signs which could indicate potential swallowing difficulties include ^{[1] [2]}:

• History of choking ^[2]
• Recurrent chest infections (due to food or liquid entering the respiratory tract) ^[2]
• Coughing before, during or after swallowing ^[1]
• Change of breathing pattern or shortness of breath when eating/drinking ^[2]
• A rattling or gurgling voice (after liquids in particular). The voice may sound hoarse or ‘wet’ ^[2]
• Difficulty controlling food or liquid while in the mouth ^[1]
• Regurgitating food or liquid ^[1]
• Aspiration of food or liquid ^[1]
• Unexplained weight loss ^[1]
• Prolonged meal times ^[2]
• Refusal to eat or drink ^[2]
• Dehydration ^[1]
• Patient complains of a feeling of “obstruction” when swallowing ^[1]
• Patient has a dry mouth (xerostomia) ^[1]

Some patients might not acknowledge their symptoms, perhaps through embarrassment or because of difficulties in communication, for instance following a stroke. Asking open questions may be useful in helping to identify patients with swallowing difficulties such as:

• ‘Do you cough after drinking or eating?’
• ‘Do you feel that tablets / capsules stick in your throat or chest?’
• ‘How long does it take you to eat?’
• ‘Does your mouth feel particularly dry’

The carer could be asked whether the patient:

• Appears to have difficulty swallowing the tablet or capsule
• Misses taking medication because of swallowing difficulties
• Sometimes hides medication instead of taking it
• Needs to suck or chew tablets to make them easier to swallow

Guidelines for healthcare professionals state that you should always ask a patient about swallowing difficulties before prescribing a medicine and assess the reasons for this. This should be taken into consideration when prescribing medication. ^[3]

ROS000051-007 DOP October 2023