Swallowing Problems (Dysphagia) in the UK: Who Can Help

The NHS says some people with dysphagia have problems swallowing certain foods or drinks, while others cannot swallow at all. Signs include coughing or choking when eating or drinking, bringing food back up, food getting stuck in the throat or chest, and a gurgly, wet-sounding voice after eating or drinking. You may also drool and have problems chewing. Over time it can cause weight loss, dehydration and repeated chest infections.

The NHS says dysphagia is usually caused by another health condition and can happen at any age. You may be more likely to have it if you take some medicines (such as antipsychotics), have a learning disability, have inflammation in the food pipe (eosinophilic oesophagitis), have heartburn and acid reflux, have breathing problems from conditions such as COPD, or have a condition affecting the nervous system or brain, such as cerebral palsy, a stroke, dementia or multiple sclerosis. It can also follow cancer or its treatment, and babies with a cleft lip and palate can have it too.

The NHS says a doctor will examine you and may refer you to a specialist for tests in hospital, and that depending on the cause you may be referred to a speech and language therapist or a dietitian, who can give advice about swallowing and your diet. Treatment depends on what is causing it and how severe it is. It may include:

• medicines to treat acid reflux or eosinophilic oesophagitis
• swallowing therapy with a speech and language therapist
• changes to what you eat and drink, such as softer foods and thickener in drinks
• special spoons, plates and cups
• feeding tubes through the nose or a hole into the stomach
• a procedure or surgery to widen the food pipe, or injections to relax the muscles of the oesophagus

Do not change food or drink textures, or add thickener, without advice from a healthcare professional who has assessed the swallow.

• Speech and language therapists assess swallowing and offer swallowing therapy; see how to find a speech and language therapist.
• Dietitians advise on food, drink and nutrition when swallowing is affected; see how to find a dietitian.
• Occupational therapists can help with seating, positioning and adapted cutlery or cups for eating and drinking.
• Practitioner psychologists, counsellors and psychotherapists can support anxiety or fear around eating and choking.

Because swallowing problems can be a sign of a medical condition, start with your GP or NHS 111 rather than going straight to a private practitioner. If you then choose a private speech and language therapist or dietitian, check them on the HCPC register.

Whoever you choose, check their register (the HCPC register for occupational therapists, speech and language therapists, dietitians and physiotherapists) and ask about fees, session length and what progress will look like. See questions to ask a private allied health professional. On Therapist Circle, each practitioner's registration is checked when they join, and their profile shows the register and number so you can check it yourself.