An overview of the background and treatment options for the common swallowing problems associated with Parkinson’s disease. Find helpful tips and some videos on the topic below.
Simply eat, drink and swallow?
Let’s start by taking a look at an extremely complex process in our body. What does the “normal” swallowing process look like in a healthy person? Overall, the normal swallowing process is very fast.
The 3 phases of swallowing:
1st phase in the mouth
The liquid is taken into the mouth or the food is chewed. The swallowed food is collected on the tongue. The swallowing reflex is then triggered. The tongue is sucked against the palate, the nasal cavity is closed, the larynx rises and the trachea is closed by the laryngeal cover.
2nd phase in the throat
Once the swallowing reflex has been triggered, the food is transported into the pharynx. Normally, only the route into the oesophagus is now open. The windpipe and nasal cavity are closed. Swallowing is hardly possible. This phase lasts only 0.5-1 second.
3rd phase in the oesophagus
The food reaches the oesophagus and is transported from here to the stomach. Depending on the consistency of the food and liquids, this takes a total of 4-20 seconds.
Swallowing disorders in Parkinson’s – What problems can occur when swallowing if you have Parkinson’s?
I have listed here some of the most common problems that I experience with Parkinson’s patients. There may of course be other difficulties that are not mentioned.
- The food is not “swallowed”, but gets stuck in the throat and slips uncontrollably into the windpipe after swallowing.
- Food residues remain in the cheeks, which can also enter the windpipe uncontrollably over time.
- Swallowing tablets becomes a problem. The medication can get stuck in the larynx. In this case, considerable differences in the effect of the Parkinson’s medication can be observed. It can happen that the person affected does not even feel or notice this.
- For various other reasons (stiff muscles, insufficiently divided food, unfavourable swallowing posture, etc.), pieces of food or liquids enter the windpipe (aspiration) and sometimes trigger a violent cough as a protective reaction of the body.
Swallowing disorders in Parkinson’s – What can be done to make swallowing easier and prevent choking?
A very simple tip first: remember the well-known saying “You can’t speak with a full mouth!” When we speak, we breathe in automatically. If food or liquids are in the mouth, parts of them can be inhaled into the windpipe and swallowed.
- However, it is often a major challenge in everyday life not to speak at shared meals. These are opportunities for dialogue and social interaction. Talk openly about your swallowing problems in the context of your Parkinson’s disease and adapt your eating behaviour!
- When taking tablets, it can be helpful to take them with a fruit puree, e.g. applesauce. Drop the tablets into a teaspoon of apple puree and swallow everything together. Do not use dairy products such as yoghurt or similar for this “swallowing aid”. Protein-rich foods impair the effect of Parkinson’s medication, such as L-dopa. And prefer softer, low-fibre and homogeneous foods to make chewing and swallowing easier.
- Learn the “chin tuck manoeuvre”. This is a very small change in posture when swallowing that has a big effect and makes swallowing much safer. Below you will find a short video in which I show you exactly how this swallowing manoeuvre works. It’s worth investing a little time to practise it. Make it your faithful companion when eating and drinking.
- Drink from cups or glasses with a wide opening. It is also best to use the “chin tuck manoeuvre”. Drinking from a bottle makes swallowing very unsafe and often leads to liquids being swallowed.
- Do regular exercises 2-3 times a week to strengthen the tongue muscles and tongue suction exercises on the palate. Plan the exercise times precisely and find your exercise routine. It’s worth it! Below you will find a link to a video with the most important tongue exercises and a video with suction exercises.
Note:
Swallowing problems are no small matter! If you have problems in this area, you should definitely talk to your doctor about it and seek medical and therapeutic help to treat your swallowing disorder! This article does not replace a visit to the doctor or therapy!
About our author Esther Grote, speech therapist.
For more than 25 years, I have specialised in all aspects of breathing, voice, speech and swallowing. Over the years, I have specialised in the treatment of patients with neurological diseases, particularly Parkinson’s and ALS.
I often accompany my patients for several years. Through this intensive work, I have become very familiar with these diseases. I have learnt what it means for the lives of those affected and their relatives to live with Parkinson’s and other muscle diseases and it is particularly important to me to share my knowledge and experience.
You can find more information about me and my work on my website