Difficulty swallowing (dysphagia) happens 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 have pain or feel like food is stuck in the throat.

Causes

Difficulty swallowing can be a result of cancer itself, especially throat or esophageal cancers that can cause the esophagus to become restricted or narrowed. Difficulty swallowing is also a common side effect of some cancer treatments. Potential side effects of surgery, radiation treatment, or chemotherapy that can cause swallowing difficulties include:

• Soreness, pain, or inflammation in the throat, esophagus, or mouth (mucositis)
  
  
• Dry mouth, from radiation treatment or chemotherapy
  
  
• Infections of the mouth or esophagus, from radiation treatment or chemotherapy
  
  
• Swelling or constriction of the throat or esophagus, from radiation treatment or surgery
  
  
• Physical changes to the mouth, jaws, throat, or esophagus, as a result of surgery

Management

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

Your doctor may also prescribe medications to reduce inflammation and pain. Some pain medications can be given as a mouth rinse 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 a nasogastric 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, different tips may work better for some people than for others. Try different types of food and ways of eating until you find what works best. Here are some more tips.

• Eat soft, smooth foods, such as yogurt, pudding, and ice cream.
  
  
• Mash or blend foods to make homemade shakes, or moisten dry foods with broth, sauces, butter, or milk.
  
  
• Try thickening liquids by adding gelatin, tapioca, baby rice cereal, or commercial thickening products (thicker liquids can be 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 (RD) for additional advice on eating a balanced diet.

More Information

Dental Health During Cancer Treatment

Difficulty Chewing

Managing Side Effects

Last Updated: April 30, 2009