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Understanding Dysphagia: When Swallowing Becomes Difficult 

Learn what dysphagia is, the signs and symptoms, and how it is managed.

20 minutes

Lesson Outline

Are you finding it harder to swallow food, drinks, or medications or noticing these difficulties in someone close to you? You’re not alone. Swallowing difficulties, known as dysphagia, affect up to 30% of adults aged 65+.

Dysphagia is not a disease, but it can be a symptom of various health problems, including stroke, brain injury, dementia, ALS, COPD, Parkinson’s disease, cancers, and more.

After completing this lesson, you'll be able to:

  • Recognize the most common signs of dysphagia
  • Understand the physical, emotional and social consequences
  • Know when and how to seek help
  • Apply practical strategies to manage dysphagia
  • Access resources and support groups

Join Amanda and her father as they navigate the early signs of dysphagia and find ways to keep meals safe and enjoyable.

 20 minutes


⏱ 3 min read

Common red flags of dysphagia

  • Wet or gurgly-sounding voice immediately after swallowing
  • Taking a long time to chew or swallow
  • Coughing, throat clearing, or choking during or after swallowing
  • The need for smaller bites or sips

Complications of swallowing problems

There are medical/physical and emotional/social consequences associated with dysphagia.

Medical/physical consequences

Medical or physical consequences include aspiration, when food, liquid, and/or medication goes down the “wrong pipe” into the airway instead of the stomach. This can cause coughing, choking, or even lead to a bacterial lung infection called aspiration pneumonia. Sometimes aspiration happens silently, without coughing. If silent aspiration goes on for a prolonged period of time, a person may start to look or feel tired, short of breath, uncomfortable during or after meals, or run a fever at the onset of an infection.

When food, liquid, and/or medication gets left behind in the throat after swallowing, it leaves a post-swallow residue that can later slip into the airway or even make swallowing uncomfortable.

When someone has trouble swallowing, they might avoid eating or drinking as much as they need. Over time, this can lead to:

  • malnutrition (not getting enough nutrients)
  • dehydration (from reduced fluid intake)
  • sarcopenia (loss of muscle)

These problems can make a person feel weak, tired, and more at risk for other health issues.

If swallowing is difficult or painful, people might eat less, leading to noticeable and unhealthy weight loss.

Emotional/social consequences

Some of the emotional and social consequences of dysphagia include:

  • fear
  • frustration
  • lack of enjoyment while eating
  • anxiety
  • depression
  • social isolation

Some people feel pain when swallowing, making meals uncomfortable or even scary, resulting in both physical and emotional consequences.

What can you do?

If you or a loved one is experiencing swallowing problems, seek a referral to a speech-language pathologist who can assess and treat dysphagia by providing strategies to make swallowing easier and safer. Other professionals, such as occupational therapists and dietitians, can provide support for eating independently and ensuring adequate nutrition.

Staying safe

Download a handout from õ’s Aging Swallow Research Lab to get actionable tips for avoiding complications due to dysphagia. These include:

  • Take your time: Eat slowly, take small bites and sips, and don’t rush.
  • Good oral care: Brush teeth, dentures, and tongue at least twice daily. Rinse the mouth after meals to clear food and reduce bacteria.
  • Positioning: Keep head and neck in a comfortable, neutral position (avoid leaning back).
  • Watch for signs: Frequent coughing, throat-clearing, or a wet/gurgly voice after eating may signal swallowing problems. Speak to a healthcare provider.
  • Sit upright: Sit as upright as possible (in a chair or supported in bed) while eating and for at least 30 minutes after.
  • One thing at a time: Avoid talking while chewing or swallowing, and reduce distractions (e.g., TV, talking).
  • Food adjustments: Choose moist, easy-to-chew foods when possible, and take sips of liquid between bites.
  • Stay alert: Only eat or drink when awake and alert; avoid eating if overly tired, drowsy, or distracted.
  • Medication safety: Ask a pharmacist before crushing tablets. Enquire about smaller doses or liquid formulations. Don’t mix pills with thickened liquids, as it can reduce effectiveness. Mix medications with applesauce or yogurt if safe.

Where to get support

The is hosted by the Aging Swallow Research Lab at õ. The group is intended for individuals with dysphagia and their caregivers.

The supports caregivers by providing one-point access to information, services and resources so they have what they need to be successful.

The is a comprehensive resource for dysphagia education and patient support. 

will help locate a speech-language pathologist in your area so you can get started.

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Lesson Transcript

A transcript of the lesson narration.

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Lesson Handout

A summary with actionable tips on how to avoid complications from swallowing problems.

Download

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Authors

Aswini Namasivayam-MacDonald

Ashwini Namasivayam-MacDonald, PhD, SLP(C), CCC-SLP

Director, Aging Swallowing Research Lab; Associate Professor, School of Rehabilitation Science, õ

Anthony Levinson

Anthony J. Levinson, MD, MSc, FRCPC

Neuropsychiatrist; Professor; Director, Division of e-Learning Innovation, Faculty of Health Sciences, õ

Amanda Ramkishun

Amanda Ramkishun, BA, MSc

Caregiver Community Partner, Aging Swallowing Research Lab, õ

Madeleine Faur

Madeleine Faur, BHSc

Project Assistant, Aging Swallowing Research Lab, õ

About this Project

Who authored and edited this page?

This educational lesson and web page were developed collaboratively by Madeleine Faur, Amanda Ramkishun, Ashwini Namasivyam-MacDonald from the Aging Swallowing Research Lab and Dr. Anthony J. Levinson of the Division of e-Learning Innovation at õ.

Are there any important disclosures or conflicts of interest?

There are no conflicts of interest to disclose with respect to the development of this content. There was no industry funding for this content.

When was it last reviewed?

October 21, 2025.

What references and evidence were used to create this content?

  1. Alagiakrishnan, K., Bhanji, R. A., & Kurian, M. (2013). Evaluation and management of oropharyngeal dysphagia in different types of dementia: A systematic review. Archives of Gerontology and Geriatrics56(1), 1–9.
  2. Affoo, R. H., Foley, N., Rosenbek, J., Kevin Shoemaker, J., & Martin, R. E. (2013). Swallowing dysfunction and autonomic nervous system dysfunction in Alzheimer’s disease: A scoping review of the evidence. Journal of the American Geriatrics Society61(12), 2203–2213.
  3. Cichero, J. A. (2013). Thickening agents used for dysphagia management: Effect on bioavailability of water, medication and feelings of satiety. Nutrition Journal12, 54. 
  4. Finucane, T. E., Christmas, C., & Travis, K. (1999). Tube Feeding in Patients With Advanced Dementia: A Review of the Evidence. JAMA282(14), 1365. 
  5. Foley, N. C., Affoo, R. H., & Martin, R. E. (2015). A Systematic Review and Meta-Analysis Examining Pneumonia-Associated Mortality in Dementia. Dementia and Geriatric Cognitive Disorders39(1–2), 52–67. 
  6. Langmore, S. E., Terpenning, M. S., Schork, A., Chen, Y., Murray, J. T., Lopatin, D., & Loesche, W. J. (1998). Predictors of aspiration pneumonia: How important is dysphagia? Dysphagia13(2), 69–81. 
  7. Malouh, M. A., Cichero, J. A. Y., Manrique, Y. J., Crino, L., Lau, E. T. L., Nissen, L. M., & Steadman, K. J. (2020). Are Medication Swallowing Lubricants Suitable for Use in Dysphagia? Consistency, Viscosity, Texture, and Application of the International Dysphagia Diet Standardization Initiative (IDDSI) Framework. Pharmaceutics12(10), Article 10. 
  8. Patel, D. A., Krishnaswami, S., Steger, E., Conover, E., Vaezi, M. F., Ciucci, M. R., & Francis, D. O. (2018). Economic and survival burden of dysphagia among inpatients in the United States. Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus31(1), 1–7. 
  9. Ramkishun, A., Faur, M., & Namasivayam-MacDonald, A. (2024). A First-Person Account of Caring for a Parent With Dysphagia. American Journal of Speech-Language Pathology33(6), 2698–2715. 
  10. Rangira, D., Najeeb, H., Shune, S. E., & Namasivayam-MacDonald, A. (2022). Understanding Burden in Caregivers of Adults With Dysphagia: A Systematic Review. American Journal of Speech-Language Pathology31(1), 486–501. 

Disclaimer

This lesson is intended solely for educational purposes. It does not constitute medical advice and should not be used as a substitute for consultation with a qualified health care professional.

You may link to the e-learning landing page for non-commercial, educational purposes with appropriate attribution. For any other use, please contact the õ Optimal Aging Portal (info@mcmasteroptimalaging.org) for permission.