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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]
Nurse with older adult Nurse with older adult

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