Difficulty swallowing (called dysphagia) can occur at any stage of Parkinson’s disease. Signs and symptoms include difficulty swallowing certain foods or liquids, coughing or throat clearing during or after eating/drinking, and feeling as if food is getting stuck. As the disease progresses, swallowing can become increasingly compromised and food/liquid can enter the lungs, causing aspiration pneumonia.
Aspiration pneumonia is the leading cause of death in Parkinson’s.
It is important to notify a physician if there are any changes related to swallowing. Swallowing disorders are managed by a medical team consisting of a physician and a speech-language pathologist. Evaluation typically involves an interview, a physical examination of the head and neck, trials with food/liquid and if indicated, an instrumented examination, either with a moving x-ray, called videofluoroscopy (also known as a Modified Barium Swallow study) and/or by visualizing the throat with a scope (called a Fiberoptic Endoscopic Evaluation of Swallowing or FEES).
Treatment is specific to the nature of the swallowing problem, but can involve strategies to improve the safety of swallowing food and/or liquid (such as swallowing hard, tucking the chin while swallowing), diet changes (thickening liquids, softer foods), exercises, or a combination of these.
Because Parkinson disease is progressive, swallowing abilities can change over time. Sometimes the signs of a swallowing disorder can be subtle, so it is important to be vigilant.