Dysphagia and Aspiration (April, 2012)


Dysphagia is the term given to problems related to the chewing and swallowing of food and drink.

The problem with chewing and swallowing may be with the muscles of the mouth, with the coordination of the swallow, or with the muscles that propel the food down the esophagus into the stomach. Dysphagia can be a problem with any of these mechanisms needed for an individual to be able eat and drink successfully. If any of these mechanisms is not working as it should, it places the individual at risk for aspiration.


Aspiration is when some of the food or liquid taken by mouth finds its way into the lungs.

A successful swallow allows muscles to block the entrance to the lungs while the individual swallows. Dysphagia often causes that reflex not to work and then the individual may aspirate.

These two conditions often go together. Recognition of dysphagia and aspiration is the first step to instituting measures that will keep the individual from developing further complications. Most common complications from dysphagia and aspiration are recurrent pneumonia and choking. These can lead to respiratory compromise, respiratory failure, and death. There are several signs that may indicate dysphagia or aspiration.

Signs of Dysphagia and Aspiration

  • Cough that is seen with mealtimes or when drinking liquids
  • History of recurrent pneumonia
  • Prolonged chewing with each bite,
  • Difficulty in moving food to the back of the throat to initiate swallow
  • Taking a long time to swallow a single bite
  • Taking several swallows to clear a single bite from the mouth
  • Changing the posture of the neck while eating- indicating difficulty with the swallow
  • Change in voice during and just after meals

Any of these signs may indicate dysphagia or aspiration. Individuals noted to have any of these symptoms should be assessed with a swallowing evaluation. Please consult with the individual's physician regarding concerns of dysphagia or aspiration. Dysphagia cannot be diagnosed by physical exam and special testing must be done to investigate. Education of staff to be able to recognize the signs and symptoms of dysphagia will allow prompt evaluation and institution of recommendations that will decrease chances for developing complications.