What is dysphagia?
Dysphagia is when someone has difficulty eating, chewing, drinking or swallowing following a stroke.
Up to 65% of people have difficulty swallowing after a stroke.
Many people with dysphagia can be at risk of aspiration (food and/or drink entering the lung).
If dysphagia is severe, you may need to be tube fed. This can be short or long-term. Suitability for tube feeding depends on many factors, and will be discussed by the medical team and you/your family​.
What are the risks of dysphagia
People suffering from dysphagia can be at a higher risk of:
- Choking
- Dehydration and/or malnutrition
- Weight loss
- Aspiration pneumonia/chest infections
- Psychological and social distress
- Reduced quality of life
- Longer hospital stay
- Death
Signs and symptoms of dysphagia
- Coughing before or after eating/drinking
- Choking on food/drinks
- Wet/gurgly voice when eating or drinking
- Pocketing i.e. food left on the tongue and/or mouth
- Pain e.g. feeling of food sticking in the throat
- Drooling with drinks/saliva
- Food spilling out of the mouth
How to help with dysphagia
- Altering the texture of drinks and food helps reduce risks
- Thickened fluids and/or altered diet texture (e.g. pureed, mashed or soft and tender food) can make swallowing easier and safer for some people
- Thickener does not change the taste and smell of food/drink
- There are a range of thickened oral supplements if you need these to help with your nutrition
- Supplements need to be requested via referral to a dietitian or by a GP
- Foods which are crumbly, crispy, stringy or crunchy may be more difficult for some people
- Your speech and language therapist will advise on the safest food/drink options
- Your speech and language therapist may provide you with specific exercises to improve the effectiveness and safety of your swallow
- Sit upright for all eating/drinking and for 20 minutes afterwards
- Reduce distractions (e.g. TV/radio) and avoid talking when eating/drinking
- Ensure the mouth (tongue, cheeks, roof of mouth) is clean and clear, using a toothbrush if needed
- If wearing dentures, ensure they are secure before and after eating/drinking
- Feed yourself if possible
- If help is needed, the person helping should wait and watch to check you have swallowed each mouthful and sit close whilst helping
- Monitor for tiredness and change in position (e.g. slipping down the bed or chair/leaning to one side) and reposition yourself if necessary
- If assisting with feeding, be positive about modified diet/fluids which have been recommended for safety
Nutrition and hydration: things to consider
- Weakness and visual changes can affect your ability to feed yourself
- Taste changes can make eating less enjoyable
- Post-stroke pain, bowel changes, tiredness or low mood can affect your appetite
- You may feel scared or embarrassed to eat in public due to your swallowing difficulties
- Changes to concentration, attention and memory may impact on how you eat and drink
- Loss of independence (e.g. needing assistance with eating/drinking) might feel undignified
Malnutrition (unbalanced amount of nutrients or food to stay healthy)
Malnutrition is common after stroke and can affect rehabilitation potential.
People with dysphagia may be more likely to be malnourished.
Poor nutritional status after stroke is associated with poor functional outcomes and dependency at 6 months. Malnutrition can result in infections and pressure sores and can be linked to an increase in mortality.
Further Information
Visit the following pages on the Stroke Association website:
You can also contact your local community stroke team.
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