Managing Dysphagia in Adults: Causes, Symptoms, and the Role of Speech Therapy

If you want help managing dysphagia in adults, you are not alone. Dysphagia means trouble swallowing, and it can affect many adults. By learning about its causes, symptoms, and how speech therapy can help, you can support safe swallowing at home. Understanding these steps makes it easier to improve comfort, prevent risks, and enjoy a better quality of life.

Table of Contents

• What Is Dysphagia?
• Common Causes of Dysphagia in Adults
• Symptoms of Swallowing Disorders
• How Dysphagia Is Diagnosed
• Speech Therapy for Managing Dysphagia in Adults
• Dietary Tips for Easier Swallowing
• Frequently Asked Questions

What Is Dysphagia?

Dysphagia means having trouble swallowing foods or liquids. When managing dysphagia in adults, it helps to know that swallowing is a process. It starts with chewing, then moving food through the throat, and finally sending it to the stomach. If something goes wrong at any step, a person may cough, choke, or even end up with food in their airway. This can lead to lung infections or other serious problems.

Two Main Types of Dysphagia

1. Oropharyngeal Dysphagia:
   This type involves trouble starting the swallow. It often happens because of muscle weakness in the mouth or throat. Strokes or certain brain disorders can cause this.

2. Esophageal Dysphagia:
   This type makes it hard for food to pass down the tube (esophagus) to the stomach. Narrowing, damage, or blockages in the esophagus often cause this problem.

Why Early Help Matters:
If left untreated, dysphagia can lead to poor nutrition, dehydration, or lung infections. By seeking help and using speech therapy, many adults can learn safe ways to swallow and lower their health risks.

Back to Table of Contents

Common Causes of Dysphagia in Adults

Several health issues can lead to swallowing difficulties. Knowing the cause helps guide treatment.

Stroke:
A stroke can harm the brain areas that manage the muscles used for swallowing. After a stroke, people may need speech therapy to rebuild muscle strength and relearn safe swallowing methods.

Brain and Nerve Disorders:
Conditions like Parkinson’s disease, multiple sclerosis, or ALS weaken swallowing muscles. As these worsen over time, swallowing can become harder. Early therapy can slow these effects and help keep swallowing safe.

Head and Neck Cancer:
Treatment for cancer (surgery, radiation, or chemotherapy) in the head or neck can damage nerves and muscles. After treatment, speech therapy can help restore strength and guide safer swallowing.

Dementia:
Memory loss and thinking problems can affect the ability to chew or swallow. People may forget to chew, take too large bites, or not swallow at all. Careful supervision, changes to food texture, and speech therapy help manage these issues.

Chronic Reflux (GERD):
Long-term acid reflux can scar and narrow the esophagus. This makes it tough for food to pass. Treating reflux and doing swallowing exercises can restore easier swallowing over time.

Aging:
As people age, muscles weaken. This natural change can make swallowing harder, especially with certain foods. Simple exercises, safer eating habits, and advice from a speech therapist can help older adults swallow more comfortably.

Back to Table of Contents

Symptoms of Swallowing Disorders

Look for these signs if you suspect dysphagia:

• Coughing or choking during meals
• Feeling like food is stuck in the throat or chest
• Drooling or trouble handling saliva
• Pain when swallowing
• Food or liquids coming back up (regurgitation)
• Unplanned weight loss
• Frequent lung infections from food getting into the airway

Spotting these signs early can make managing dysphagia in adults much simpler. Early action helps prevent worse problems down the road.

Back to Table of Contents

How Dysphagia Is Diagnosed

A healthcare team, often including a speech-language pathologist (SLP), will use several steps to check swallowing skills:

1. Clinical Swallow Evaluation:
   An SLP watches how a person swallows different foods and liquids. They note any coughing, gagging, or delay in swallowing.

2. X-ray Tests (VFSS):
   A Videofluoroscopic Swallow Study (VFSS) shows how foods move from the mouth to the throat. The test uses a special X-ray to watch swallowing in real-time.

3. Endoscopic Examination (FEES):
   A thin camera placed through the nose allows the SLP to see the throat while swallowing. This test can catch problems that might not show up in a simple exam.

4. Esophageal Tests (Manometry):
   This test checks how well the esophagus muscles work. If they do not work well, it can confirm esophageal dysphagia.

By using these tools, experts can find the cause and severity of the problem. With this knowledge, they can create a personalized plan for managing dysphagia in adults.

Back to Table of Contents

Speech Therapy for Managing Dysphagia in Adults

Speech therapy is key in improving swallowing function. A speech-language pathologist will design a set of exercises and strategies to help you swallow more safely.

Swallowing Exercises:

• Shaker Exercise: Lifts the head while lying down to strengthen muscles that help open the throat.
• Mendelsohn Maneuver: Teaches the throat muscles to hold a certain position, improving coordination.
• Effortful Swallow: Encourages a strong, focused swallow to clear food better.

Compensatory Techniques:

• Chin Tuck: Tucking the chin helps close the airway and keep food moving down the right path.
• Head Turn: Turning the head to one side can direct food away from weaker areas in the throat.

Food and Liquid Changes:
A speech therapist may suggest changing the thickness of liquids or the texture of food. Softer foods or thickened liquids often pass more easily, lowering the risk of choking.

Caregiver Guidance:
Caregivers also learn how to help during meals. They can remind the person to take small bites, sit up straight, and allow time between swallows.

By working on these exercises and methods, managing dysphagia in adults becomes more realistic. These steps often lower the risk of problems like choking or aspiration, making mealtimes safer and more pleasant.

Back to Table of Contents

Dietary Tips for Easier Swallowing

In addition to speech therapy, simple changes in eating and drinking habits can help:

1. Choose the Right Foods:
   Softer or mashed foods are easier to swallow. Examples include mashed potatoes, applesauce, yogurt, or pureed soups. Avoid dry, crumbly foods or sticky foods that can cause choking.

2. Thickened Liquids:
   Adding thickeners to liquids helps them move more slowly, making it easier to control swallowing. Thickened beverages can prevent liquids from slipping into the airway.

3. Smaller Portions and Slower Eating:
   Small, frequent meals can ease pressure and prevent fatigue. Taking slow, careful bites and chewing well also helps. Sip drinks between bites to clear the throat.

4. Upright Position:
   Sit up straight, at a 90-degree angle, during and after meals. Staying upright for about 30 minutes after eating helps prevent food or liquids from traveling back up or into the airway.

5. Stay Hydrated:
   Drinking enough liquids is important, but do so carefully. Follow your SLP’s advice about the right thickness and amount to avoid dehydration.

6. Avoid Problem Foods:
   Steer clear of dry bread, crackers, peanut butter, or tough meats. If unsure, ask your SLP or a dietitian for a list of foods that match your swallowing level.

By making these small changes, eating and drinking often become less stressful. Over time, these habits can lead to better swallowing and fewer risks.

Back to Table of Contents