Problems with swallowing can result from a variety of medical conditions including Parkinson’s Disease, Cerebral Palsy, stroke, or head injuries. If you have difficulty swallowing, your doctor may refer you to a Speech Language Pathologist for an evaluation and to learn things you can do to make sure you are able to eat and drink safely, including changing the consistency of the foods you eat and drink.
Problems with swallowing are more than just an annoyance. Our bodies need food and water to survive. People who have difficulty swallowing can easily become dehydrated and poorly nourished. Difficulty swallowing can also pose a risk that food or liquids will “go down the wrong way” and cause choking. Since problems swallowing are often caused by damaged nerves or weakened muscles in the mouth and throat, people with swallowing problems also may not be able to cough effectively to clear food from the airway. Liquids that get into the lungs can cause infections including pneumonia.
Swallowing is a complex process that involves over 50 pairs of muscles in the mouth and throat. In order for swallowing to be successful, liquids are caught by the tongue and worked to the back of the mouth. Nerves and muscles work together when you swallow to close the airway and move liquid down the esophagus into the stomach. For people with difficulty swallowing, the tongue is not able to catch the liquid when it enters the mouth and move it to the back where it can be swallowed. To help this process, your doctor may instruct you to drink only thickened liquids. Water and other standard drinks have a very thin consistency. Your doctor may prescribe liquids that are the consistency of nectar (like tomato juice), honey-thick, or even as thick as pudding, depending on how much difficulty you are having with swallowing. A variety of products are available that can be added to liquids to create the correct thickened consistency.
It’s important to remember that if you are instructed to drink thickened liquids, you should never drink through a straw. The straw bypasses the tongue and deposits liquids at the back of the mouth.