News & Media

Hard to Swallow

Media Contact Joe Poelker
Release Date: 05/04/2018 By Megan Ellis
St. Anthony’s Speech Therapist
Upon hearing difficult news, we’ve all heard someone say, “That’s got to be a hard pill to swallow.” Have you ever really thought about this phrase? Have you ever experienced difficulty trying to swallow a pill? If you have, you know how uncomfortable or sometimes even painful and scary it can be. While occasional trouble getting a pill down smoothly is not uncommon, if this happens regularly, your body is trying to tell you something. Difficulty swallowing pills can be a sign of dysphagia, which is a problem occurring within the swallowing process.
Trouble with swallowing is not isolated to swallowing pills. Many people experience difficulty chewing or swallowing foods, liquids, and sometimes even their own saliva. Swallow difficulty can be devastating for the person having the trouble, and it can be heartbreaking for loved ones watching it happen. Someone who has problems swallowing might feel embarrassed to eat in front of others, might feel afraid of choking, or might take a very long time to eat a small meal.
The consequences of dysphagia (impaired swallowing) can be significant: choking, weight loss, malnutrition, dehydration, and even aspiration pneumonia. If you or a loved one is dealing with swallowing concerns, it is important to see a doctor. Your doctor may tell you to consult with a swallowing therapist (a speech-language pathologist or SLP), with a gastroenterologist (GI doctor), or with both.
The medical professionals will gather a detailed history of your issue, might perform a clinical swallow evaluation in which they analyze your swallow in the office, and might recommend a modified barium swallow or other upper-GI testing. During the barium swallow, the SLP will assess your swallow using an x-ray video to see what happens as food and liquids move down your throat. Those results will lead the SLP to make recommendations based on your swallow structures and how they are functioning. The SLP may recommend the best textures, optimal positioning for eating, strategies to improve swallow safety or function, and may recommend a swallow exercise program targeting areas that are malfunctioning.
An outpatient SLP can work with patients to help them learn about swallow recommendations and how to correctly perform any swallow strategies or exercises. There are some cases when it would be appropriate for the SLP to use a specialized treatment called VitalStim to help the swallow muscles function better. Swallowing treatment may range from just a few therapy sessions to several sessions, based on the patient’s level of need, level of independence, and potential for recovery.
Some swallowing problems are very mild, while others may be severe. Some swallowing problems may come on suddenly, while others may slowly develop over time. Unfortunately, many swallowing issues can get worse over time, especially if left untreated. A wide variety of underlying medical conditions can lead to dysphagia, including but not limited to: stroke, head/neck cancer, Parkinson’s, multiple sclerosis (MS), dementia, or brain injuries. The SLP will provide you with information about what to expect. Like most conditions, the sooner the intervention, the better. If you have any questions or concerns about your swallow function, let your doctor know right away.