AARP Hearing Center
I’m Having Trouble Swallowing Food and Liquids
If food is sticking in your throat or liquids make you cough, finding the cause can help make it safer and easier to swallow
5-minute read
James Yates
Lately I’ve had difficulty swallowing food and liquids. What does it mean and what can I do about it?
Swallowing is something we do hundreds of times a day without giving it a second thought. So when food suddenly seems to stick, liquids make you cough or you find yourself struggling to get a bite down, it can be uncomfortable and unsettling.
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This difficulty is called dysphagia, and it’s something I want you to take seriously, particularly when it’s new or keeps happening.
Let’s look at the process. Swallowing is a remarkable dance of coordination involving your tongue, throat, nerves and muscles. A problem can develop anywhere along this route, and it isn’t a rare complaint, especially among older adults. In fact, a large meta-analysis found that nearly 1 in 3 adults over age 60 living at home had dysphagia when assessed by reliable swallowing tests. The analysis also found that among people living in nursing homes, more than half had the condition.
An important clue to figuring out what’s causing this problem is where you feel the sensation. If you have trouble getting food from your mouth into your throat, or you cough or choke as you begin swallowing, the problem may involve the mouth or throat. This difficulty can occur after a stroke or with neurological conditions such as Parkinson’s disease.
If food seems to go down normally but then feels stuck in your throat or chest, the esophagus may be involved. Causes can include acid reflux or something called Schatzki’s ring, which is a thin band of tissue that narrows the lower esophagus and makes it difficult for solid food to pass into the stomach. It could also be another abnormality of the esophageal muscles.
Your doctor will want to know what you experience and may ask: Is it solids, liquids or both? Does swallowing hurt? Do you cough or choke? Does food feel stuck? Have you lost weight or begun avoiding certain foods? These details help determine what should be evaluated. Depending on the symptoms, you may be referred to a gastroenterologist, an ear, nose and throat specialist or a speech-language pathologist who specializes in swallowing. Tests may include a barium swallow study or a modified barium swallow study, an endoscopy or other examinations that show how food and liquid move through your swallowing pathway. For instance, when there’s ongoing difficulty swallowing, an endoscopy to look for structural, tissue or other abnormalities is usually ordered.
The encouraging part is that treatment is often possible. If acid reflux is responsible, lifestyle changes and medication may help. A narrowed area of the esophagus can sometimes be widened during an endoscopic procedure. And when the problem involves the muscles or coordination of swallowing, a speech-language pathologist can teach you specific techniques and exercises that make swallowing safer and easier.
In the meantime, change the way you eat. Sit upright rather than eating in bed or reclining on a couch. Take smaller bites, chew thoroughly and slowly, and finish swallowing before putting more food in your mouth. Avoid talking while you are chewing. If thin liquids make you cough or choke, don’t thicken them yourself. Ask a swallowing specialist what consistency is safest for you. If you have trouble with pills, ask whether the medication can be taken in another form rather than crushing a pill on your own. (If you are a caregiver for someone with dysphagia, read Cooking and Caregiving: Tips for Providing Special Dietary Needs for some great advice.)
Why be so careful? Dysphagia can lead to dehydration and inadequate nutrition, but one of the most serious complications is aspiration, or food or liquid entering the airway. That can cause a dangerous condition called aspiration pneumonia, an infection caused by inhaling something other than air into your lungs.
Don’t wait for a dramatic choking episode before mentioning your swallowing trouble to your doctor. If it is recurring, bring it up. It may be something relatively straightforward to treat, and finding the cause can help prevent a much more serious problem. Of course, if you suddenly cannot swallow or breathe, or you believe food is completely stuck in your throat, seek emergency care immediately.
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