Difficulty Swallowing or Dysphagia

Aprobado por la Junta Editorial de Cancer.Net, 07/2019

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 their throat.

Causes of swallowing problems

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

Difficulty swallowing also happens after some cancer treatments:

  • Radiation therapy

  • Surgery

  • Chemotherapy, less commonly

Some side effects of cancer treatment may also cause swallowing difficulties:

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

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

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

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

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

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

Swallowing therapy

Relieving side effects is an important part of cancer care and treatment. This is called palliative care or supportive care. Talk with your health care team about any symptoms you have. Make sure to bring up any new symptoms or a change in your symptoms.

Many people also benefit from starting swallowing therapy before cancer treatment, especially those with cancer in the throat. Therapy may include:

  • Speech pathologist. Your doctor may refer you to a speech pathologist. This professional helps people use muscles in the mouth and throat. He or she will teach you new ways to swallow and to avoid choking and gagging. Some are Board Certified in Swallowing and Swallowing Disorders (BCS-S).

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

  • Feeding tube. Sometimes swallowing problems make it hard to eat a healthy 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. This depends on 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. Chew slowly and thoroughly.

  • Eat small, frequent meals.

  • Avoid foods that need a lot of chewing.

  • Sit upright when eating or drinking.

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

  • Avoid dry, coarse, or hard foods.

  • Drink meal replacement or nutritional supplement beverages.

You can also ask your doctor for a referral to meet with a registered dietitian. He or she will give advice on eating a balanced diet.

Related Resources

Dental and Oral Health

Did You Know That Cancer Treatment Can Affect Your Mouth?

Difficulty Chewing

More Information

American College of Gastroenterology: Dysphagia

National Institute of Dental and Craniofacial Research: Cancer Treatment and Oral Health