Swallowing therapy

Swallowing therapy is a treatment for people who have difficulty swallowing, a condition called dysphagia. Dysphagia can make it hard to eat, so you may not get enough nutrients, calories, or fluids. It can also increase your risk of choking or aspirating food, liquids, or saliva. Aspiration means that food or liquid enters your lungs.

Dysphagia develops when the muscles and nerves in your mouth, throat, or esophagus (tube that carries food and liquid to your stomach) are weak or damaged. Swallowing therapy uses exercises to strengthen and improve coordination of these muscles. Therapy can make swallowing easier and reduce your risk of choking or other complications.

Penn Medicine offers comprehensive care for swallowing disorders in our Speech and Language Pathology program. Our ear, nose, and throat specialists, speech-language pathologists, and other experts work together to build your individualized swallowing therapy plan. We use the latest evidence-based techniques to evaluate and treat all forms of dysphagia.

Dysphagia can result from nervous system, brain, or muscle disorders such as stroke. Dysphagia can also gradually develop as you age. We may recommend swallowing therapy if you have any of the following symptoms:

• Coughing or gagging while eating
• Difficulty breathing when swallowing
• Drooling
• Feeling of food getting stuck in your throat
• Food or liquid leaking from your mouth
• Pain or discomfort when swallowing
• Problems chewing food before swallowing
• Slow eating
• Weight loss, dehydration, or malnutrition related to difficulty swallowing

Before swallowing therapy, we do a thorough physical exam and review your symptoms. We may perform tests to accurately diagnose the type and underlying cause of dysphagia. Tests may include:

• Modified barium swallow: A modified barium swallow lets us see if food and liquid enter the lungs. During this test, you consume food or liquid containing barium, a substance that coats your gastrointestinal tract. The barium highlights the food and liquid in the X-rays we take to examine your throat and esophagus.
• Flexible endoscopic evaluation of swallowing (FEES): FEES enables us to watch how you swallow using live video. During this procedure, your health-care provider inserts an endoscope (tube with a light and camera) into your nose and down your throat.

The frequency of swallowing therapy varies depending on your needs. Most people have weekly sessions, each lasting about an hour. It’s important to practice the exercises and techniques you learn with your speech-language pathologist at home. Consistent practice will improve your results.

Preparing for swallowing therapy

You don’t have to do anything special to prepare for swallowing therapy. Your health-care provider may give you instructions about eating or drinking before treatment. You should be able to take all your regular medications. Be sure to tell your health-care provider if you have any allergies.

Swallowing therapy is safe and carries few risks. During therapy, you may swallow liquids or solid foods that can cause gagging or aspiration. Tell your health-care provider if you experience any pain or discomfort during testing or treatment.

Dysphagia can have many causes, including surgery, head and neck cancer, neurological conditions, or gastroenterological conditions. Effectively treating swallowing problems means providing whole-person, coordinated care from a team of experts. Our ear, nose, and throat specialists, speech-language pathologists, gastroenterologists, neurologists, and other providers work together to provide all the treatments you need from one source.