What to Do If It's Hard to Chew or Swallow

Not long after Debbie McClure was diagnosed with Sjogren’s syndrome, an immune system disorder that causes dry mouth, she sat down to a roast beef dinner. She was still adjusting to her condition. So she didn’t fully realize how not having enough saliva, which helps move food from the mouth and down the throat, would make it hard to swallow, especially with dry foods -- like her overcooked roast beef.  

“I attempted to swallow a bite, but it lodged in my throat,” says McClure, a writer based in Ontario, Canada. She grabbed a glass of water and, sip by sip, she was able to dislodge the piece of meat.

When a medical condition creates problems with chewing or swallowing, the simple act of eating can become anything but. Pain in the mouth, stiffness or discomfort in the jaw muscles, or problems with your teeth can make it tough to chew solid foods. A condition called dysphagia can create a delay in the swallowing process in either your throat or what’s known as the pharynx (the digestive tube between the esophagus and mouth) that might also make it hard for you to swallow without coughing or choking.

“If you’re having trouble swallowing, even if it’s pills, you should let your physician know,” says Brian Hedman, a speech pathologist and specialist in swallowing disorders at Cleveland Clinic. “A speech pathologist can do an assessment and offer tricks or techniques to help you or someone you’re caring for to swallow safely.”

Try these six tips to make sure that what you eat gets where it’s going without problems along the way.

1. Tweak the 3 Ts

They are tastes, temperature, and textures. When you vary these in your diet, it helps keep the mouth awake and on task, Hedman says.

Switch off between bites of something cold and tart, like lemon ice, with something warm and bland, like mashed potatoes. 


2. Sit Upright

During meals, and for 45 to 60 minutes after eating, aim for a 90-degree posture with your head tilted slightly forward, Hedman suggests.

“If you’re having difficulty getting food from the front of the mouth to the back of the mouth, try a reclined position,” he says. “Otherwise, sitting upright is the best position for eating and drinking.”

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3. Limit Distractions

It’s important to stay focused during mealtime, especially for someone who’s had a stroke or is in the early stages of dementia, says Kristi King, RDN, a spokeswoman for the Academy of Nutrition and Dietetics. 

“A person with Alzheimer’s may pay more attention to an open window or the TV in the room than what’s in their mouth,” she says.

4. Keep Your Mouth Moist

Before meals, swab the inside of your mouth with a disposable oral swab or, better yet, brush your teeth “to help moisturize the mouth so swallowing will be easier,” Hedman says.

And keep a drink handy during meals. McClure sips water or something else that isn’t bubbly between every single bite to help move food along. If water or other thin liquids cause you to cough, use an over-the-counter liquid thickener, Hedman suggests. These thicken without changing the taste or appearance of your drink.  

“I also avoid medications like over-the-counter cold and allergy tablets, or sleeping aids that contain antihistamines,” McClure says. “Antihistamines are [drying], and most definitely will affect the amount of dryness in my mouth, eyes, and nose.”

5. Tiny Is Better

Cut up solid foods into bite-size pieces to minimize the risk of choking.

“I’ve learned that even finger foods must be cut up into very small portions,” McClure says. “When I indulge in something like potato chips or popcorn, I make sure I eat one at a time, slowly, and in very small bites.”

6. Swallow Often


You might 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.

Try "alternating bites and sips,” Hedman says. “If you have difficulty sucking liquid all the way up a straw, cut the straw down so there is less distance for the liquid to travel.”

WebMD Feature Reviewed by William Blahd, MD on February 06, 2016

Sources

SOURCES:
Debbie McClure, Ontario, Canada.

National Institute of Arthritis and Musculoskeletal and Skin Diseases: “What Is Sjogren’s Syndrome?”

American Society of Clinical Oncology.

National Institute on Deafness and Other Communication Disorders: “Dysphagia.”
Brian Hedman, speech pathologist, Cleveland Clinic.
Kristi King, RDN, Academy of Nutrition and Dietetics spokesperson.

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