Getting foods and liquids from the mouth to the stomach is a complex process, involving coordination between the many muscles in the mouth and throat and the autonomic nervous system.
Depending on a variety of individual factors, Parkinson’s disease (PD) can affect muscular control of all or part of this process, says Leslie Harper, MS, CCC-SLP, a speech/language pathologist at the University of Alabama at Birmingham
“Common signs of swallowing issues in Parkinson’s include the feeling that food is stuck in your throat, coughing or choking while eating or drinking, and noticing your voice sounding ‘wet’ or ‘gurgly’ or your eyes watering while eating or drinking,” she says. “Swallowing problems can also lead to unintentional weight loss and poor nutrition.”
People with PD can also lose control of the food or liquid in their mouths, resulting in it spilling into the throat too soon. “This can cause food or liquid to enter the windpipe before a person has triggered a swallow,” Harper says. “There can also be residual food or liquid in the throat post-swallow that is at risk of entering the airway.”
These issues raise the risk for inhaling fluid or stomach contents into the lungs (called pulmonary aspiration), which can cause pneumonia.
“If you notice changes in your swallowing, consider asking your physician for a referral to a speech pathologist, who can pinpoint your unique swallowing issues and address them with the techniques specifically for you,” suggests Harper.
Here are some general strategies for eating and drinking more safely:
1. Maintain good posture.
Stay seated upright in a straight-backed chair with knees and hips at 90° and with the head slightly tilted forward—while eating and drinking.
2. Stay focused on eating and drinking.
Avoid distractions like television or devices.
3. Eat slowly, and don’t talk while eating or drinking.
4. Take small bites of food and small sips of liquid.
5. Clear your throat.
If you feel food or liquid caught in your throat, cough gently or clear your throat, and swallow again before you take a breath. Repeat if needed.
6. Stay in an upright position (seated or standing) for about 30 minutes after meals.
7. Stay hydrated.
Some PD medications can cause dry mouth, which makes it harder to swallow. If you don’t make enough saliva, try sucking on a popsicle or hard sour candy or moistening food (add a sauce or broth or dunk crusty bread into milk, for example) to make it easier to swallow.
