Blog - Speech for Life | Speech Pathology Insights

Swallowing difficulties or dysphagia

(dis-fay-ja) from the Greek dys (disordered) phagia (eating).

What are signs I have a swallowing issue?

‍Some examples are:

coughing or choking on foods and drinks
feeling like food or medications are getting stuck in the throat
eating taking a lot longer than normal
difficulty getting the food or drink to pass through into the throat
food or drink spilling from the lips
unexplained chest infections (aspiration pneumonia) occurring

Swallowing difficulties can occur due to many reasons:

dry mouth (xerostomia)
lack of teeth or ill fitting dentures
stroke
traumatic brain injury
progressive neurological conditions such as Parkinson's, MND, Multiple Sclerosis
head and neck cancer
respiratory disorders such as COPD
Functional Neurological Disorder

Swallowing difficulties can occur on food, drink, saliva and medications.

What can I expect in a swallowing assessment?

Ruth Hartman has worked with swallowing assessment and management for over 20 years in acute and rehabilitation hospitals as well as in outpatient and community settings. She has worked with a wide variety of causes of swallowing issues and endeavours to support you to manage your swallowing issues safely, as well as rehabilitate your swallow whenever possible, to allow you to eat and drink more freely.

Ruth will gather a full case history so that your issue can be understood in the context of you and your life. Ruth will then conduct a thorough swallowing assessment which will include:

assessing your face, mouth and swallowing muscles
watching you eat and drink
listening to the swallow using a stethoscope (cervical auscultation)
trialling strategies and techniques to improve your swallowing safety
onward referral if required for a Modified Barium Swallow (moving x-ray of the swallow) or FEES (Fibreoptic Endoscopic Evaluation of the Swallow) for further objective assessment
Education about the swallowing mechanism so you can fully understand why your issue may be occurring
onward referral for medical input where required
Letter to your GP or specialist

What can I expect from swallowing treatment sessions?

Ruth will tailor treatment options to support your individual swallowing issues. These may include:

Rehabilitation exercises to strengthen your swallowing mechanism over time. These will be individualised to suit your particular needs.
Examples are:
- Expiratory Strength Muscle Training (EMST-150)
- McNeil Dysphagia Therapy Programme (MDTP)
- general swallowing exercises
Compensatory strategies to improve your swallowing safety immediately
Examples are:
- modifying your food (e.g. making it softer, easier to chew, more moist) or drinks (thickening them so they move more slowly and give the swallow more time to occur)
- drinking after every few mouthfuls of food to assist with flushing down food
- taking medications with apple puree or medication lubricant
Environmental changes to maximise your swallowing safety immediately
‍ Examples are:
- using different utensils to support your mealtime management e.g. a two handled cup
- ensure good upright position at mealtimes
- minimising background noise so you can focus on your food

Useful Resources

IDDSI – International Dysphagia Diet StandardisationInitiative
For information on how to modify food and fluids toimprove swallowing safety www.iddsi.org
Speech Pathology Australia’s fact sheet on swallowing
https://www.speechpathologyaustralia.org.au/Public/Public/Comm-swallow/Swallowing.aspx
McNeil Dysphagia Therapy Programme (MDTP)
https://fdi2.com/mdtp
Expiratory Strength Muscle Training
https://emst150.com

Client questionnaires

To submit completed questionaires, please email them to ruth@speechforlife.com.au.

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