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Swallowing Problems

Reviewed by: HU Medical Review Board | Last reviewed: September 2023

When you live with MS, you could form other related health problems. One condition, called dysphagia, causes trouble swallowing and may require treatment.1

Swallowing problems with MS

It is normal to have trouble swallowing every once in a while. You may have eaten too fast or neglected to chew your food thoroughly. But dysphagia is different. It happens more often and is a serious medical condition. It is more difficult and takes more time to move food or liquid to your stomach after you swallow it. Sometimes you may not be able to swallow at all.1

Chewing and swallowing require many muscles in your mouth and throat to work together. MS impairs the nerves that control these muscles. You may have trouble swallowing along with:2

  • Throat clearing when you eat or drink
  • Numbness in your mouth and throat
  • A sensation of food stuck in your throat
  • Coughing or choking when you eat or drink

A 2023 study found that 45 percent of people with MS have dysphagia. This rate is much higher than those without the condition.3

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Other issues linked to swallowing problems

When you have trouble swallowing, it can trigger other health problems, such as:1

  • Weight loss and a lack of nutrients and fluid. It is tough to get enough food and fluid with dysphagia.
  • Food or liquid in your airway. This can happen when you try to swallow, and the substance carries bacteria into your lungs.
  • Choking. Food that blocks the airway can eventually cause death.

How are MS swallowing problems evaluated and diagnosed?

A speech or language pathologist evaluates and diagnoses swallowing problems. This specialist will first take your clinical history. This is followed by a thorough check of the muscles in your mouth and throat and your ability to control them.2

They could also ask you:1

  • Are your symptoms frequent or infrequent?
  • Do certain foods make your symptoms better or worse?
  • Do you have trouble swallowing solids, liquids, or both?
  • Does swallowing make you cough or gag?
  • Which gave you trouble swallowing first, solids or liquids?
  • After swallowing food, do you bring it back up?
  • Have you ever vomited food or a black substance?
  • Has trouble swallowing caused you to lose weight?

A swallowing assessment also usually includes a modified barium swallowing study. During this procedure, a technician gives you a solution of barium to swallow. This makes the different parts of your mouth and throat visible on the X-ray video.2

The swallowing study records the movements of the structures of your mouth, throat, and esophagus. This happens as you chew and swallow different types of food and liquids. The test helps to spot the exact location of a swallowing problem and what is causing it.2

How are MS swallowing problems treated?

Speech or language pathologists usually treat swallowing problems with exercises to build up your swallowing muscles. You may also learn safer eating and swallowing techniques and changes to your diet.1,2

Even with treatment, you could still have trouble swallowing safely or getting enough nutrients. Your doctor could then suggest a feeding tube, which gives nutrients without swallowing. A feeding tube is used for the most severe cases of dysphagia.1

If you live with MS and have swallowing problems or have concerns about swallowing problems arising in the future, talk with your doctor. They can work with you to develop a treatment plan.