Managing swallowing problems in Parkinson's

If you have Parkinson’s, you may experience swallowing problems. Here, Nic Vasselin, an NHS speech and language therapist, tells us more about these issues and how they can be managed.

It can be common for people with Parkinson’s to experience changes to swallowing. Difficulties tend to increase as the condition progresses.

Some of the typical issues include problems with eating and drinking, difficulties swallowing medication and drooling.

You may find that chewing takes more effort, and that some foods or drinks can make you cough. Or you might have a feeling of food or tablets sticking in your throat.

These problems can be caused by changes in the timing, coordination and strength of the muscles you need for swallowing.

It’s natural to feel concerned about these difficulties and the impact on both your health and confidence. For example, if you’re experiencing swallowing issues, you may find you don’t enjoy eating and drinking as much as you did. This might mean that you don’t want to socialise or eat out as often as you might like to.

Our aim is to use your expertise about your condition and our expertise on the swallowing mechanism to work together and find solutions to help you.

Getting the right support

Speech and language therapists are able to assess, diagnose and support people with Parkinson’s to manage their swallowing issues.

At your first appointment, your speech and language therapist will ask you some questions about what swallowing symptoms you’re experiencing and how they’re affecting you day-to-day.

You might be asked to eat and drink a small amount, so that they can observe and assess your swallowing in action. Afterwards, your speech and language therapist will discuss the results with you, talk with you about options and see how you want to proceed.

Treatments might include:

  • expiratory muscle strength training (EMST). This can help improve your swallow and cough response to reduce the risk of food or drink going down your windpipe
  • swallow rehabilitation exercises. These are exercises designed to improve the strength and coordination of your swallowing muscles
  • recommending changes to your body or head position while eating, and strategies or techniques to use when eating and drinking

If needed, we can also advise on changing the texture of your food and drinks to make swallowing easier and liaise with pharmacies or GPs to ensure medications are suitable for swallowing. Sometimes, we may refer you for more specialist investigations of your swallow.

Our aim is to use your expertise about your condition and our expertise on the swallowing mechanism to work together and find solutions to help you.

Getting help early

Ideally you should see a speech and language therapist as early as possible, because problems with swallowing can increase as your Parkinson’s progresses. The earlier we see you, the earlier we can work with you to make positive changes. We can also tailor any advice or support to your individual needs.

But there are some tips which can be helpful to support eating and drinking. These include:

  • sitting in a supportive chair at a table for meals
  • eating and drinking at a steady pace
  • taking smaller mouthfuls of food and drink and chewing foods well
  • taking some extra swallows can help to clear any food from your mouth or throat
  • not talking with food in your mouth
  • avoiding having lots of distractions around you when eating
  • keeping your mouth and teeth clean - oral care is very important

Seeing a speech and langauge therapist

Speech and language therapists work either in the NHS or privately. Your GP or another health professional can refer you to a therapist, or you can refer yourself.