Oesophageal Swallowing Difficulties
What Are Oesophageal Swallowing Difficulties?
Oesophageal dysphagia affects the lower part of the swallowing process, where food moves from the throat into the stomach.
People may feel that food sticks after swallowing or experience discomfort when eating or drinking.
Speech and Language Therapists specialise in swallowing difficulties affecting the mouth and throat (oropharyngeal dysphagia). If difficulties are thought to involve the oesophagus, further assessment is usually carried out by a Gastroenterology or Upper Gastrointestinal (GI) specialist.
Living with Oesophageal Swallowing Difficulties
- Recognise the Symptoms
- Seek Specialist Advice
- Eat Comfortably
- Maintain Good Nutrition
Common Symptoms
Symptoms may include:
- Difficulty swallowing
- Food sticking after swallowing
- Pain or discomfort when eating
- Coughing during meals
- Regurgitation (food coming back up)
- Heartburn
- Bad breath or an unpleasant taste
- Frequent throat clearing
- Persistent cough
- Unintentional weight loss
When to Seek Further Assessment
If your symptoms suggest difficulties in the oesophagus, your healthcare professional may consider referring you to:
- Gastroenterology
- Upper Gastrointestinal (GI) services
These specialist teams can carry out investigations to identify the cause of oesophageal swallowing difficulties and recommend appropriate treatment.
Eating and Drinking More Comfortably
Many people find the following strategies helpful.
Choose Softer Foods
Choose foods that are naturally soft and moist.
Adding sauces can make food easier to swallow, including:
- Gravy
- White sauce
- Cream
- Custard
- Mayonnaise
- Tomato ketchup
Some people may also find mashed or blended foods more comfortable.
Foods That May Be More Difficult
Take extra care with:
- Bread
- Tough meats
- Dry foods
If eating bread is difficult, try:
- Soft sandwich fillings
- Removing crusts
- Dipping bread into soup
Foods and Drinks That May Trigger Symptoms
Some people find it helpful to reduce:
- Citrus fruits
- Tomatoes
- Fruit juice
- Alcohol
- Caffeine
- Smoking
Practical Eating Tips
Simple changes can make meals more comfortable.
Try to:
- Eat slowly.
- Take small mouthfuls.
- Chew food thoroughly.
- Swallow twice if needed.
- Take small sips of drink between mouthfuls.
- Eat smaller meals more often.
- Sit upright while eating.
- Remain upright for around 30 minutes after meals.
- Avoid eating within two hours of going to bed.
- Avoid eating immediately before exercise.
Some people also find sipping sparkling water during meals helpful.
Looking After Your Nutrition
If swallowing difficulties are affecting your weight, it’s important to maintain your calorie and protein intake.
Ways to increase nutrition include:
Fortify Everyday Foods
You can add extra calories by using:
- Butter
- Olive oil
- Mayonnaise
- Cheese
- Cream
- Full-fat milk
- Condensed milk
Adding skimmed milk powder to full-fat milk can also increase protein and calorie intake.
Eat Little and Often
Rather than large meals, try eating:
- Smaller meals every 2–3 hours
- Nourishing snacks
- High-calorie puddings between meals
Nutritional Drinks
Products such as:
- Complan
- Meritene
can help increase calorie and protein intake.
These are best taken between meals so they don’t reduce appetite at mealtimes.
Monitor Your Weight
If weight loss continues or you’re worried about your nutritional intake, speak to your GP or another healthcare professional.
Further Information
If you have ongoing swallowing difficulties, your healthcare professional may recommend referral to a Gastroenterology or Upper Gastrointestinal (GI) specialist for further assessment.
If your swallowing difficulties affect the mouth or throat, Speech and Language Therapy may also be involved in your care.
Looking After Your Mouth
Maintaining good oral hygiene is an important part of managing swallowing difficulties.
Keeping your mouth clean helps reduce bacteria and may lower the risk of chest infections caused by aspiration.
To maintain good oral health:
- Brush your teeth or clean your mouth at least twice a day.
- Clean your mouth even if you wear dentures or have no natural teeth.
- Consider using SLS-free toothpaste if regular toothpaste produces too much foam.
- Speak to your therapist or GP if you experience a dry mouth.
- Clean your mouth after meals if food tends to collect inside your mouth.
Everyday Tips for Safe Eating and Drinking
These simple tips can help make eating and drinking safer:
- Sit fully upright and stay alert during meals.
- Avoid eating or drinking while lying down.
- Reduce distractions such as televisions or radios.
- Take small bites and small sips.
- Eat slowly and avoid rushing meals.
- Make sure dentures fit comfortably.
- Avoid dry, crumbly or difficult-to-chew foods unless advised otherwise.
- Follow the recommendations provided by your Speech and Language Therapist.
Further Information
If you have concerns about swallowing difficulties or have noticed changes in your eating or drinking, speak to your healthcare professional or contact your local Speech and Language Therapy service.
Specialist Community Neurology Service
Speech and Language Therapy
Bristol, North Somerset and South Gloucestershire
Telephone: 0300 125 5550
Email: sirona.neuro@nhs.net
