What should I do if I have a problem swallowing?

ACS Answer

Difficulty swallowing occurs when a person has trouble getting food or liquid down the throat. A person may gag, cough, spit, or feel pain when trying to swallow. There can be several causes. It may be a temporary side effect of chemotherapy or radiation therapy to the throat or chest area. Also, it may be caused by a treatable infection of the mouth or esophagus, such as thrush.

What to look for

• Gagging, coughing, or vomiting of food
• Weight loss
• Food building up in mouth
• Drooling out of the side of mouth; excessive saliva
• Little or no saliva
• Inside of mouth is red, shiny, glossy, or swollen
• Open sores in mouth
• Pain in the throat or mid-chest with swallowing
• White patches or coating on inside of mouth

What to do

• Eat bland foods that are high in calories and protein, and soft and smooth in consistency, such as pudding, gelatin, ice cream, yogurt, or milkshakes.
• Use a straw for liquids and soft foods.
• If you have pain, use a local anesthetic or pain reliever, such as viscous lidocaine (by doctor's prescription) or liquid Tylenol.
• Mash or puree foods so the consistency is like baby food.
• Refrigerate food (the coldness helps numb the pain) or serve at room temperature (patients with esophageal pain may feel worse with cold liquids; if so, serve food at room temperature).
• Try crushed ice and liquids at meals.
• Drink liquids that have some consistency, such as smoothies, because they are easier to swallow than are clear liquids.
• Crush medicines in pill or tablet form; mix with juice or in applesauce, jelly, or pudding. (Check with your nurse or pharmacist first because some medicines react negatively with some foods.)
• Sit up while eating and drinking.

Do not

• Force yourself to eat if you cannot swallow
• Eat foods that need a lot of chewing, such as meats, chewy candy, or raw whole vegetables
• Eat or drink hot, spicy foods or liquids
• Consume alcohol, citrus fruits or drinks, carbonated beverages, crackers, nuts, or chips

Call the doctor about any of the following symptoms

• If you gag, cough, or choke more than usual
• If you have a severe sore throat
• If you have a red, shiny mouth or ulcers in the mouth or on tongue
• If you have a fever greater than 100.5°F taken by mouth
• If you have difficulty breathing
• If you have chest congestion

Related Resources

Find books that cover this and other cancer topics at the American Cancer Society bookstore.

Recommended Consultation

You should consider discussing this question with your doctor or health care team.

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