Difficulty Swallowing or Dysphagia

Approved by the Cancer.Net Editorial Board, 05/2016

Difficulty swallowing is called dysphagia. It means having trouble passing food or liquid down the throat. Some people may gag, cough, or choke when trying to swallow. Others may feel like food is stuck in the throat.

Causes of swallowing problems

One cause is cancer, especially mouth, throat, or esophageal cancers. Cancer growing in these parts of the body may narrow the passages.

Additionally, difficulty swallowing occurs after some cancer treatments:

  • Radiation therapy

  • Surgery

  • Chemotherapy, less commonly

Side effects of cancer treatment that may cause swallowing difficulties include:

  • Fibrosis, which is scarring or stiffness in the throat, esophagus, or mouth.

  • Infections of the mouth or esophagus. These may occur after radiation therapy or chemotherapy.

  • Swelling or narrowing of the throat or esophagus. This may occur after radiation therapy or surgery.

  • Physical changes to the mouth, jaws, throat, or esophagus from surgery.

  • Mucositis, which is soreness, pain, or inflammation in the throat, esophagus, or mouth.

  • Xerostomia, commonly called dry mouth. This may occur from radiation therapy or chemotherapy.

Swallowing therapy

Relieving side effects is an important part of cancer care and treatment. This is called symptom management or palliative care. Talk with your health care team about any symptoms you experience. This talk should include any new symptoms or a change in symptoms.

 Don’t wait for swallowing problems to begin. Many patients benefit from starting swallowing therapy before cancer treatment. Swallowing therapy is especially beneficial for people with cancer in the throat.

  • Speech pathologist visit. Your doctor may refer you to a speech pathologist. This professional will teach you new ways to swallow and avoid choking and gagging. A speech pathologist specializes in helping people use muscles in the mouth and throat. Some have Board Certification in Swallowing and Swallowing Disorders (BCS-S).

  • Medication. Your doctor may prescribe medication if you have pain swallowing. Painful swallowing is called odynophagia. Some medications reduce inflammation and pain. Other medicines treat mouth or throat infections. Some pain medicines come as mouth rinses used before eating.

  • Feeding tube. Sometimes, swallowing problems make it hard to eat a nutritious diet. So doctors place a tube through the nose or abdomen into the stomach. This helps deliver food and liquid until swallowing becomes easier.

Eating tips for people with difficulty swallowing

Certain approaches may work better for some people than for others. Factors include the severity and cause of swallowing problems.

Try different types of food and ways of eating. Find what works best. And remember to eat a nutritious diet. Your food should have enough calories, protein, vitamins, and minerals.

Consider these tips:

  • Eat soft, smooth foods, such as yogurt or pudding.

  • Mash or blend foods. Or moisten dry foods with broth, sauce, butter, or milk.

  • Try thickening liquids. Add gelatin, tapioca, baby rice cereal, or commercial thickening products.

  • Use a straw to drink liquids and soft foods.

  • Eat cold or room-temperature foods to reduce pain.

  • Take small bites, and chew slowly and thoroughly.

  • Sit upright when eating or drinking.

  • Eat small, frequent meals.

  • Choose food high in calories and protein if you are losing weight. Such food includes eggs, milkshakes, casseroles, and nutritional shakes.

  • Avoid dry, coarse, or hard foods.

  • Avoid foods that need a lot of chewing.

  • Drink meal replacement or nutritional supplement beverages.

Ask for a referral to meet with a registered dietitian. This professional gives advice on eating a balanced diet.

More Information

Dental and Oral Health

Difficulty Chewing

ASCO Answers Fact Sheet: Dental and Oral Health (PDF)