Adult Swallowing Difficulties

How speech pathology helps adults with swallowing difficulties

Adult Swallowing Difficulties

A real swallowing difficulty is not when someone makes you laugh and you snort drink up your nose, cough and splutter. For some, who have real swalowing difficulties related to muscle tone issues or neurological changes, these can present as very real risks to their health. Food and drink entering the airway falling into warm moist lungs can lead to chronic chest infections and cause potentially even more significant impacts with aspiration pneumonia.

To understand the causes of swallowing difficulties, you first need to understand the steps for swallowing. You swallow up to 1.5 litres of your own saliva a day, so you are doing this unconsciously all day long.  

Swallowing difficulties in young children are more commonly related to anatomical or physiological development affecting timing and strength of the muscles involved. This is different from feeding issues which is to do with the behaviours aorund foods and textures. At tinmes this can be hard to discern the difference and you will need a specialist speech pathologost to guide you. Adult swallowing difficulties are more commonbly associated with neurological conditions such as MND, MS or a stroke. A swallowing disorder is also called dysphagia.

At Talkshop Speech Pathology we work with adults and children with swallowing and feeding issues. Read here for more information about how we assess and treat feeding and swallowing concerns in children.

How do you swallow?

Swallowing happens in three main stages, or phases. You can have a problem in one or more of these phases to have dysphagia. They include:[1]

  • Oral phase – sucking, chewing, and moving food or liquid into the throat.
  • Pharyngeal phase – starting the swallow and squeezing food down the throat. You need to close off your airway to keep food or liquid out. Food going into the airway can cause coughing and choking.
  • Oesophageal phase – opening and closing the oesophagus, or the tube that goes from the mouth to the stomach. The oesophagus squeezes food down to the stomach. Food can get stuck in the oesophagus. Or, you may throw up a lot if there is a problem with your oesophagus.

How does a swallowing problem occur?

Dysphagia can occur at any age, but it’s more common in older adults. The causes of swallowing problems vary, and treatment depends on the cause. There are many conditions that can cause swallowing problems. Some medications can cause a dry mouth, which makes it hard to chew and swallow. Other causes include the following:

  1. Damage to your part of your brain or nerves from:
  1. Problems with your head or neck, such as:
“Food and drink may be at risk of falling into an open airway if a body’s natural reflexes and sensations aren’t working”

Why does this need speech pathology?

Signs of dysphagia and when to seek help

General signs of a swallowing difficulty include:[7][8]

  • Coughing during or right after eating and/or drinking
  • A wet or gurgly sounding voice during and/or after eating or drinking
  • Extra effort or time needed to chew or swallow
  • Food or liquid leaking from your mouth onto your clothes
  • Food getting stuck in areas of your mouth
  • Having a hard time breathing during and/or after meals
  • Rapid weight loss
  • Excess saliva

As a result, you may have experienced:

  • Dehydration or poor nutrition
  • Food or liquid going into the airway, called aspiration
  • Pneumonia or other lung infections

You may feel embarrassed when eating. You may feel bad about your swallowing problems and want to eat alone.

“Our mission is always to help you maintain the quality of your life through the enjoyment and safe consumption of food and drink”

Swallowing Assessment

At Talkshop Speech Pathology, our speech pathologists will assess you to see how you are eating and drinking. Our clinicians are experienced in working with adults and children with swallowing disorders. Swallowing assessments are usually done in the comfort of your own home.

The Speech Pathologist will:[9]

  • Ask you about your health, past illnesses, surgeries, and your swallowing problems
  • Do an oro-motor assessment. This is an assessment of your cranial nerves and the anatomy and physiology of the muscles supporting the swallowing process.
  • We will assess how your well your swallowing is able to cope with different food and drink textures
  • Assess how swallowing ability can also change with fatigue. One of the things we observe is whether you are safe to eat and drink throughout a mealtime without becoming too tired and being at risk of choking or aspirating.
  • Review how well you are able to independently follow swallowing strategies during mealtimes
  • Review level of support needed to prepare food and drinks.
  • Refer you to do further testing if needed.

What dysphagia therapy looks like

The focus of the treatment you need will depend on the problems you have. At Talkshop our speech pathologists can work with you to improve how you swallow. We might suggest:[10]

  • Treatment to help you use your muscles to chew and swallow
  • Ways you should sit or hold your head when you eat
  • Strategies to make your swallow better and safer
  • Trialling differently textured food or drinks which are an easier texture to swallow safely.

Typically we will book in a block of sessions. Sessions are usually 45 mins in length. Swallow therapy sessions are usually done in your home.

We may refer you to other health professionals to further assist or monitor issues associated with swallow issues:

  • GP – e.g management of underlying condition
  • ENT – e.g  to review possible reflux
  • Dietitian – e.g to ensure adequate nutrition and hydration
  • Pharmacist – e.g to manage swallowing tablet medications

If you have concerns about someone’s swallowing safety please contact us immediately or contact your GP.

If you have questions about your child’s swallowing/feeding/eating difficulties please call us or and read here for more information

Our FREE Discovery Session is ideal for anyone with any questions relating to speech, stuttering, language, literacy, social skills, swallowing, and voice.

This is an opportunity for us to give some information on how to monitor your concern and give you advice on how to start self-managing any issues immediately.

Discovery Sessions can help you understand if an assessment or therapy is needed, how Speech Therapy would work, and if appropriate, help you book in.


1 “Anatomy and Physiology of Feeding and Swallowing – Normal and ….” Accessed 15 Jan. 2019.

2 “Dysphagia in the elderly: management and nutritional considerations.” 30 Jul. 2012, Accessed 15 Jan. 2019.

3 “Dysphagia – Symptoms and causes – Mayo Clinic.” 3 Feb. 2018, Accessed 15 Jan. 2019.

“Management of dysphagia following radiation therapy and tracheostomy.” Accessed 17 Jan. 2019.

“Rehabilitation of Dysphagia Following Head and Neck Cancer.” Accessed 17 Jan. 2019.

6 “Oral Health and Swallowing Problems – NCBI – NIH.” 15 Sep. 2013, Accessed 17 Jan. 2019.

“Dysphagia after Stroke: an Overview – NCBI – NIH.” Accessed 15 Jan. 2019.

“Difficulty Swallowing After Stroke (Dysphagia).” 15 Nov. 2016, Accessed 15 Jan. 2019.

“A Survey of Australian Dysphagia Practice Patterns. – NCBI.” 20 Sep. 2017, Accessed 15 Jan. 2019.

10 “Dysphagia therapy post stroke: An exploration of the practices and ….” Accessed 15 Jan. 2019.