What is Dysphagia?

Dysphagia is the medical term used for difficulty or inability to swallow. It may present as difficulty with sucking, swallowing, drinking, chewing, eating, controlling saliva, taking medication or protecting the airway. It is a disorder that can occur at any time across the lifespan and can be short or long term.

Normal swallowing is when food and drink pass from the mouth to the stomach. A healthy adult swallows at least 500 times per day. It is a very complex task and uses 26 muscles and many nerves to coordinate the split second timing needed to safely swallow. Mistimed movements can lead to food or drink ‘going down the wrong way’ and entering your lungs. 

If food and fluid enters the lungs, pneumonia or choking can occur. 

Common Causes in Adults

• Age related changes – Presbyphagia
• Stroke
• Brain Injury
• Dementia
• Progressive neurological conditions such as Motor Neurone Disease and Parkinson’s Disease
• Chronic Obstructive Pulmonary Disease
• Cancer of head and neck
• Genetic conditions from childhood such as Cerebral Palsy
• Medications that effect the nervous system can cause dysphagia by impacting swallow movements or causing a dry mouth

 Clinical Evaluation of Swallowing (CES) 

A Clinical Evaluation of Swallowing (CES) is when a speech pathologist comes to assess your swallow function. Some signs that there are problems with the swallow include coughing, gagging or choking when eating and drinking. 

During a CES the following phases are assessed:

• Pre-oral phase – how the food/drink is brought to the mouth
• Oral phase – how the food/drink is manipulated in the mouth
• Pharyngeal phase – how the food/drink moves down the throat
• NB: Oesophageal phase (how the food/drink moves down the oesophagus) is not assessed as it is outside speech pathology scope of practice. To assess this phase, a gastroenterologist may be required
• Refer to ‘Safe Swallowing Strategies’ brochure 

Food and Drink Texture Modifications 

FOOD 

• Regular diet (IDDSI Level 7)
• Easy to Chew Diet (IDDSI Level 7) 
• Soft & Bite-Sized Diet (IDDSI Level 6) 
• Minced & Moist Diet (IDDSI Level 5) 
• Pureed Diet (IDDSI Level 4) 

DRINKS 

• Thin Fluids
• Mildly Thick Fluids (IDDSI Level 2)
• Moderately Thick Fluids (IDDSI Level 3)
• Extremely Thick Fluids (IDDSI Level 4) 

YOUR FOOD AND DRINK: 

FOOD: _________________________________ 

FLUIDS: ________________________________ 

COMPENSATORY STRATEGIES: _______________________________________

Further Information & Resources

Online patient education videos

• Dr Ianessa Humbert, Ph.D., CCC-SLP -> Patients -> Videos
• https://ianessahumbert.com/videos/

Speech Pathology Australia 

• Resources for the Public - Fact Sheets: Dysphagia

St Vincent's Private Hospital Toowoomba Speech Pathology

07 4690 4052