Dysphagia (difficulty swallowing) occurs when a person has trouble getting food or liquid to pass down the throat. Some people may gag, cough, or choke when trying to swallow, while others may have pain or feel like food is stuck in the throat.

Causes

One cause is the cancer itself, especially throat or esophageal cancers, which can cause the esophagus to become restricted or narrowed. It is also a common side effect of some cancer treatments, such as chemotherapy, radiation therapy, and surgery. Side effects of cancer treatment that may also cause swallowing difficulties include:

• Mucositis(soreness, pain, or inflammation in the throat, esophagus, or mouth)
  
  
• Xerostomia (dry mouth) from radiation therapy or chemotherapy
  
  
• Infections of the mouth or esophagus from radiation therapy or chemotherapy
  
  
• Swelling or constriction (narrowing) of the throat or esophagus from radiation therapy or surgery
  
  
• Physical changes to the mouth, jaws, throat, or esophagus as a result of surgery

Management

Relieving side effects—also called symptom management, palliative care, or supportive care—is an important part of cancer care and treatment. Talk with your health care team about any symptoms you experience, including any new symptoms or a change in symptoms.

Your doctor may refer you to a speech therapist (a professional who specializes in helping people use the muscles in the mouth and throat), who will teach you how to swallow more easily and avoid choking and gagging while eating and drinking.

In addition, your doctor may prescribe medications to reduce inflammation and pain. Some pain medications are mouth rinses used directly before eating. People with a mouth or throat infection, such as a fungal infection like thrush, may be given medication to treat the infection.

If swallowing problems make it hard to eat a nutritious diet, it may be necessary to receive food through a tube (usually using a tube that passes through the nose into the stomach) until swallowing becomes easier.

Diet and eating tips for people with difficulty swallowing

Depending on the severity and cause of swallowing problems, certain approaches may work better for some people than for others. Try different types of food and ways of eating until you find what works best, while remembering the goal to eat a nutritious diet that has enough calories, protein, and vitamins and minerals. Here are some more tips.

• Eat soft, smooth foods, such as yogurt, pudding, or ice cream.
  
  
• Mash or blend foods, or moisten dry foods with broth, sauce, butter, or milk.
  
  
• Try thickening liquids by adding gelatin, tapioca, baby rice cereal, or commercial thickening products. Thicker liquids are often easier to swallow.
  
  
• Use a straw to drink liquids and soft foods.
  
  
• Eat foods that are cold (to help numb pain) or at room temperature.
  
  
• Take small bites, and chew slowly and thoroughly.
  
  
• Sit upright when eating or drinking.
  
  
• If you are losing weight, eat small, frequent meals, and choose foods that are high in calories and protein, such as eggs, milkshakes, casseroles, and nutritional shakes.
  
  
• Avoid dry, coarse, or hard foods and foods that need a lot of chewing.
  
  
• Meet with a registered dietitian for additional advice on eating a balanced diet.

More Information

Diet and Nutrition

Difficulty Chewing

Dental and Oral Health During Cancer Treatment

Managing Side Effects

Last Updated: January 06, 2012