The Cleveland Clinic

Parkinson's Disease:
Other Medical Concerns: Swallowing Problems

Introduction

Many people with Parkinson's disease have difficulty swallowing because they lose control of their mouth and throat muscles. As a result, chewing and managing solid foods can be difficult.

Swallowing problems increase the risk of aspiration (inhaling fluid or stomach contents) and pneumonia in people with Parkinson's disease. For some, following special swallowing techniques is sufficient to alleviate swallowing problems. For others, dietary changes may be necessary.

How Are Swallowing Problems Diagnosed?

If you are having trouble swallowing, contact your doctor. He or she will recommend a speech pathologist to carefully examine your swallowing abilities and evaluate your aspiration risk. A swallowing study using foods and liquids of varying consistency under video-fluoroscopy may be given.

How Can I Make Chewing and Swallowing Easier?

The way you sit and the type of food you eat can influence your ability to swallow. Here are some suggestions to make chewing and swallowing easier.

Positioning

  • Sit upright at a 90-degree angle.
  • Tilt your head slightly forward.
  • Remain sitting or standing upright for 15-20 minutes after eating a meal.

Dining environment

  • Minimize distractions in the area where you eat.
  • Stay focused on the tasks of eating and drinking.
  • Do not talk with food in your mouth.

Amount and rate

  • Eat slowly.
  • Cut your food into small pieces and chew it thoroughly.
  • Do not try to eat more than 1/2 teaspoon of your food at a time.

Swallowing

  • You may need to swallow two or three times per bite or sip.
  • If food or liquid catches in your throat, cough gently or clear your throat, and swallow again before taking a breath. Repeat if necessary.
  • Concentrate on swallowing frequently.

Saliva management

  • Drink plenty of fluids.
  • Periodically suck on popsicles, ice chips, lemon ice or lemon-flavored water to increase saliva, which will increase how often you swallow.

Food consistency

If chewing is difficult or tiring:

  • Minimize (or eliminate) foods that require chewing, and eat more soft foods.
  • Puree your foods in a blender.
  • If thin liquids cause you to cough, thicken them with a liquid thickener (your speech pathologist can recommend one for you.) You can also substitute thin liquids with thicker liquid choices such as nectars for juices and cream soups for plain broths.

Tips for Taking Medications

Crush your pills and mix them with applesauce or pudding. But, some medications, such as Sinemet CR should not be crushed because this can affect how the medications work. Ask your pharmacist for his/her recommendations on which pills should not be crushed and which medications can be purchased in a liquid form.

Reviewed by the doctors at The Cleveland Clinic Neuroscience Center
Edited by Charlotte E. Grayson, MD, WebMD, March 2004.

Portions of this page © The Cleveland Clinic 2000-2005


Last Editorial Review: 1/31/2005 4:25:55 AM