Swallowing and Parkinson’s: Why It Matters and What You Can Do
Most of us never think about swallowing; it happens automatically, hundreds of times a day. But for people living with Parkinson’s disease, this simple act can become increasingly difficult.
Known as dysphagia, swallowing issues affect about 80% of people with Parkinson’s at some stage, and can have serious consequences if left untreated.
Let’s explore the causes of swallowing issues in PD and what to do if they arise.
Why Parkinson’s Can Make Swallowing Harder
Parkinson’s disease changes the way muscles move. Rigidity, slowness, and reduced coordination don’t just affect the arms and legs; they also involve the muscles used for chewing and swallowing.
- Rigidity & reduced coordination: Chewing can become slower, jaw movements stiffer, and the tongue less agile.
- Weakness or poor coordination in the throat muscles: Can cause food or liquid to linger or enter the airway before the swallow is complete.
- Timing between breathing and swallowing: Breathing pauses briefly during a swallow to keep food or drink out of the lungs. With Parkinson's, that reflex can be delayed, increasing the risk of aspiration.
Small Signs That Point to a Bigger Problem
Sometimes, swallowing problems can be obvious, such as coughing or choking while eating or drinking. However, despite no outward signs, “silent aspiration” can still happen when food or liquid enters the lungs unnoticed.
Here are other signs to look out for:
- A wet or gurgly voice after meals
- Frequent throat clearing
- Drooling
- Sensation that food is stuck in the throat
- Mealtimes may take much longer than before
- Unexplained weight loss and dehydration
Impact of Swallowing Issues
When swallowing isn’t functioning as smoothly as it should, it can lead to other issues, such as:
- Aspiration pneumonia: A lung infection caused when food, liquid, or saliva enters the airway and lungs instead of the stomach.
- Malnutrition: Eating less or avoiding certain foods due to difficulty swallowing.
- Dehydration: Drinking less to avoid coughing or choking.
- Unintentional weight loss: Reduced food intake or increased effort needed to eat.
- Fatigue and muscle weakness: Due to poor nutrition and hydration.
- Frequent respiratory infections: From food or liquid particles repeatedly entering the airway.
- Reduced quality of life: From the stress of eating, loss of enjoyment at meals, or avoiding social situations involving food.
- Anxiety or depression: Linked to the emotional and social impact of eating difficulties.
Swallowing changes in Parkinson’s can start subtly, but over time, these small shifts can place added strain on the body.
How Therapy, Tools, and Techniques Can Help
The good news is dysphagia in Parkinson’s is treatable, and the best outcomes happen when intervention begins early. The first step is getting a thorough evaluation from the right specialist.
Specialists for Swallowing Issues
A Speech-Language Pathologist (SLP) trained in swallowing disorders is the primary professional to see for an assessment.
They can perform a detailed clinical examination and order tests such as a modified barium swallow study or a fiberoptic endoscopic evaluation of swallowing. These tests help pinpoint where and how the swallowing process breaks down so that treatment can be tailored to your needs.
Neurologists, dietitians, and occupational therapists may also be effective at treating swallowing issues.
Simple Changes That Can Help
Once the problem is understood, an SLP can recommend practical strategies to make swallowing safer.
These may include:
- Changing food textures, such as softening solids or thickening liquids.
- Changes in posture, like tucking the chin slightly when swallowing, to reduce the risk of aspiration.
- Environmental changes, such as eating in a calm setting without distractions, sitting fully upright, and taking smaller bites or sips.
- A feeding tube may be considered in more serious cases to maintain nutrition and hydration while protecting the lungs.
Exercises for Swallowing Issues
Specific exercises can strengthen the muscles involved in swallowing and improve coordination. Some people can benefit from speech and vocal exercises that help strengthen the throat muscles.
Other exercises, such as the Shaker exercise, the Mendelsohn maneuver, and effortful swallows, target different parts of the swallowing mechanism. These are always best learned under the supervision of an SLP, since correct technique is essential for safety and effectiveness.
Los Angeles Resources for Swallowing Issues with PD
For those living in the Los Angeles area, there are many resources available for people living with Parkinson’s who are experiencing swallowing issues.
You can start with a referral from your neurologist or MDS to a speech-language pathologist at the hospital where you receive your care.
A FREE therapy regimen at Cal State LA tailored to people with Parkinson’s disease to improve their voicing, and in turn, their swallowing.
Find local therapists and speech language pathologists trained in the LSVT LOUD program — specifically for people with PD —on their site.
Find local therapists and speech language pathologists via their online search tool.
Contact the CSUN Speech & Hearing Clinic at 818-677-2856 for the latest Information.
SoCal Swallow provides specialized speech and swallowing evaluations and therapy for people with PD.
Visit the PCLA resources page for more, and check out our YouTube channel for more in-depth conversations with doctors and specialists.
When Should I Get Treatment for Swallowing Issues?
In Parkinson’s disease, swallowing changes can be gradual, and waiting for symptoms to become severe is risky.
Even mild signs, like coughing occasionally when drinking, or a change in voice after meals, should prompt an evaluation. Regular swallowing assessments are also recommended for people living with PD, even if you haven’t noticed a problem, since early intervention can prevent complications like aspiration pneumonia.
Acting early reduces health risks and helps maintain nutrition, hydration, and quality of life.
Taking Charge of Swallowing Health in Parkinson’s
Swallowing issues in Parkinson’s are not inevitable, but they are common and should never be ignored. The good news is that with the proper evaluation, targeted therapy, and practical strategies, many people with Parkinson’s can continue to eat and drink safely.
PCLA is here to help, whether it is referring you to a care provider or providing educational resources to help you better understand Parkinson’s disease.
With timely care, mealtimes can remain not only safe but also enjoyable!
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