MS and Trouble Swallowing

Multiple sclerosis (MS) is a chronic, progressive condition that affects the central nervous system. As MS causes damage to the nerves, it can cause a disruption in how a person moves, thinks, and feels. One of the symptoms MS can cause is difficulty swallowing, which is referred to medically as “dysphagia.”

The normal swallowing process

There are several things that occur during a normal swallow reflex. When things are working properly, this happens without much thought, but when difficulties arise, it can be helpful to understand how the process normally functions. Experts have categorized the swallowing process into three phases:

  1. Oral phase – in the oral phase, food is chewed and combined with saliva to form a bolus. The tongue helps move the food around the mouth for chewing and moves the bolus to the back of the mouth.
  2. Pharyngeal phase – in the pharyngeal phase, the vocal folds close and the epiglottis covers the larynx (the entrance to the lungs) to keep food and liquid out.
  3. Esophageal phase – in the esophageal phase, the bolus moves into the esophagus, the tube that connects the mouth to the stomach.1

Symptoms of trouble swallowing

Dysphagia is characterized by being unable to swallow, having food get stuck in your throat, coughing while swallowing, or a choking sensation. Disturbances to any of the three phases can cause difficulty swallowing.1,3

If an obstruction of food causes choking, immediate attention is required. Fast action can save the life of a person who is choking. Abdominal thrusts, also called the Heimlich Maneuver, can be done by another person or by yourself to force air up the windpipe and expel the lodged food or object.4

How common is it among people with MS?

It’s difficult to give an exact estimate on how many people with MS experience dysphagia. As with many features of MS, each person experiences symptoms uniquely. One study that measured how people with MS swallowed found that 43% of them experienced abnormal swallowing, although almost half didn’t complain of it.2

In our Multiple Sclerosis In America 2017 survey, 24% of survey respondents noted they were currently experiencing trouble swallowing at the time of the questionnaire, and 57% said they had experienced trouble swallowing at some point. Dysphagia that occurs with MS may be occasional, or it may happen frequently or almost all the time.

What you can do

If you’re experiencing trouble swallowing, it’s important to speak to your doctor about it. Your doctor needs to understand all your symptoms to provide you with the best approach for managing your symptoms, and you may also receive a referral to a Speech Language Pathologist. Despite their title, Speech Language Pathologists can assess, diagnose, and treat swallowing disorders, in addition to their expertise in speech and language disorders.5

In addition to getting professional help, some people find that eating slowly, sitting up straight while eating and drinking, and chewing food thoroughly can help reduce the risk of choking.3

View References
  1. Stages of Swallowing, University of Wisconsin Health. Available at https://www.uwhealth.org/voice-swallow/stages-of-swallowing/11463. Accessed 10/24/17.
  2. Thomas FJ, Wiles CM. Dysphagia and nutritional status in multiple sclerosis. J of Neurology. 1999 Aug; 246(8):677-682.
  3. Dysphagia, Mayo Clinic. Available at https://www.mayoclinic.org/diseases-conditions/dysphagia/basics/symptoms/con-20033444. Accessed 10/24/17.
  4. Abdominal thrusts, MedlinePlus, U.S. National Library of Medicine. Available at https://medlineplus.gov/ency/article/000047.htm. Accessed 10/24/17.
  5. American Speech-Language-Hearing Association. Available at https://www.asha.org/Students/Speech-Language-Pathology/. Accessed 10/24/17.

Comments

View Comments (6)
  • LuvMyDog
    1 year ago

    I was diagnosed with MS 35 years ago. 35 years ago the worst symptom I had was some pain and a great deal of fatigue. Fast forward…so many other things have come into focus and one thing especially….doctors like to THINK they are as brilliant as too many actually believe they are but the truth be told…..they are mere human beings who instead of becoming bankers or engineers or ????, they became, by some miracle, physicians. And like getting any degree, some graduate at the very top of their class and some at the middle and sadly, many at the bottom. I’ve met them at all levels. I let them know where I think they landed. I am outspoken and couldn’t care less who likes my unfiltered conversations and remarks. I am my best and only advocate because I choose to be. I read, I study, constantly and by appointment time, I’m ready to listen and comment. If I feel something will be a waste of my time and energy, I do not participate. I have met one neurologist in the past 36 years who I feel actually knew what he was talking about and helped me many times, I’ve yet to meet another like him.

  • Kelly McNamara moderator
    1 year ago

    Hi @LuvMyDog. As you commented, being your own advocate when working with your healthcare team is so important! Thanks for sharing and for being a part of the community! – Kelly, MultipleSclerosis.net Team Member

  • dhawken
    1 year ago

    My wife was referred to a Speech Language Pathologist for some serious Esophageal phase issues. We were unfortunately correct in our assessment of the title – it was a completely useless endeavour. The speech pathologist had to be convinced to scan lower on the esophagus, despite the referring doctor (and my wife in the appointment) giving clear indications of the location of the issues. When finally scanning the lower esophagus, the pathologist was surprised to find blockages there from the extremely tiny test bite given to my wife for the scan.

    All in all, a frustrating and ultimately useless visit and diagnosis. I would wager anyone with these issues has already tried “eating slowly, sitting up straight, and chewing food thoroughly” before visiting a doctor, and spending our day getting poked, prodded, and scanned to hear another one say it is useless. Our Speech Pathologies watched my wife do all those things with the tiniest of bites, observed blockages on the scan, and still gave her that advice at the conclusion and nothing else. We left without any new info or plan to improve the issue.

    Like a great many other doctor visits for MS related health issues, this was a complete waste and felt like a doctor/insurance money grabbing scheme. No useful info came out of it, as was easily predicted going to a “Speech Pathologist” for these serious issues. These interactions with health “professionals” has made us extremely jaded and doubting of the usefulness in continued time/money/hope.

  • Kelly McNamara moderator
    1 year ago

    I’m so sorry your wife went through all of this @dhawken. As other community members have mentioned, sometimes the process to finding the right healthcare team is so tough and frustrating! I hope you’re wife is feeling better now. Thoughts with your wife and family! – Kelly, MultipleSclerosis.net Team Member

  • lalkana
    1 year ago

    A friend of ours died because of this a few years ago. Her swallowing issues were so bad everything she ate had to be pureed, and she never ate or drank unless someone was with her. Still, she got choked on lunch one day and stopped breathing. Her husband tried CPR, but got nowhere. By the time help arrived, her brain had been without oxygen for too long. She died in the hospital two days later.

    Just another one of the horrors MS inflicts on us.

  • Kelly McNamara moderator
    1 year ago

    @lalkana, I’m so sorry to hear about your friend. Swallowing issues can be one of those lesser known symptoms to others outside of the MS community, but this symptom can have such an impact. Thinking you and those close to your friend. – Kelly, MultipleSclerosis.net Team Member

  • Poll