Swallowing problems are very common after a stroke. Almost half of people who have a stroke will have some difficulties in the first few weeks.

Why do they happen?

Swallowing is a complicated task, which needs your brain to coordinate lots of different muscles. 
 
Sometimes a stroke can damage the parts of your brain that do this. This affects your ability to swallow.
 
Doctors use the term dysphagia to describe problems with swallowing.

How do you know if you have swallowing problems?

You should be checked to see if you can swallow safely within the first few hours of being in hospital. So if you do have problems, your stroke team should pick up on them very quickly. 
 
However, problems aren’t always obvious, so it’s good to know what to look out for. Some signs of swallowing problems are:
 
  • coughing when you’re eating or drinking
  • food or drink going down the wrong way
  • feeling that food is stuck in your throat
  • still having food or drink left in your mouth after you’ve swallowed
  • not being able to chew food properly
  • a croaky or ‘wet’ sounding voice
  • dribbling
  • taking a long time to swallow or finish a meal
  • having to swallow a lot to clear your throat.
If you can’t swallow safely then food and drink may be getting into your airway and lungs. This is called aspirationIt can lead to infections and pneumonia. So it’s extremely important that swallowing problems are spotted early.
 
However, aspiration doesn’t always have noticeable signs. This is called silent aspiration. You will need an assessment with a trained professional to know that you are actually swallowing safely.

Does it get better?

Swallowing problems do get better and most people are able to swallow safely again within the first few weeks. 
 
Only a small number of people have problems that last longer than this, and even fewer are left with permanent problems.

Are there treatments that can help?

If you have swallowing problems, you’ll be referred to a speech and language therapist.
 
They will complete an assessment with you and talk to you about what can help. This could include:
 
  • thickening your drinks with special powders to make them easier to swallow 
  • eating soft food, like mashed potato, or pureed food, which is very smooth, like custard
  • changing the temperature of foods and drinks, as hot things are more difficult to swallow
  • change how and when you eat, such as eating small amounts throughout the day, rather than three big meals.
Your speech and language therapist will explain exactly what foods are safe for you to eat and suggest any other changes that they think you should make.
 
If you’re not getting enough food or water, your stroke team may talk to you about tube feeding. This means putting liquid food directly into your digestive system through a tube. 

Find out more

Read more, including practical tips to help you and your family and information about tube feeding, in our leaflet Dealing with swallowing problems.

Or for more detailed information, download our Complete guide to swallowing problems after stroke.

 

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