Parkinson's and swallowing

Why swallowing can change

Parkinson's affects how the brain controls movement. That includes the small muscles in your mouth and throat.

Chewing and swallowing can get slower and less strong. Changes can be mild at first.

Swallowing can also vary from day to day, and as medicines wear on and off.

Changes can be quiet

Some people with Parkinson's feel less when food goes the wrong way. They may not cough when it happens.

So a lack of coughing does not always mean all is well. A swallow check can show what is really happening.

What you might notice

• Meals take longer than they used to.
• Coughing or clearing your throat when you eat or drink.
• A feeling that food sticks in your throat.
• Trouble keeping food or drink in your mouth.
• Extra saliva, or drooling.
• Pills that are hard to get down.
• Losing weight without trying, or avoiding drinks.

What can help

These are options people use. You can weigh them and decide what to try.

• Make eating the only task at meals. Turn off the TV and sit upright.
• Swallowing therapy is one option. An SLP can show the technique and check whether it is working.
• Some SLPs teach programs that train a louder voice and a stronger swallow. Ask what the evidence shows for each one.
• Changing food or drink textures helps some people feel safer. It can also make meals less enjoyable, so weigh both.
• Sugar-free hard candy can help some people with drooling between meals. Skip it if you often cough or choke.
• Ask your doctor whether your medicine times and meal times line up. Some people find eating easier when their medicine is working well.
• A team that knows movement disorders well can look at drooling, dry mouth and swallowing together.
• Never stop or change a medicine on your own. Ask your doctor or pharmacist.

Drooling and dry mouth

People with Parkinson's often swallow less often. The head may tip down and the mouth may rest open. Feeling around the lips can be duller, so saliva goes unnoticed.

Some people set a timer on a phone or watch. A soft beep every minute reminds them to swallow.

Dry mouth is common with Parkinson's too, sometimes along with drooling. Medicines can play a part. Both are worth telling your team about.

Pills and Parkinson's

Pills can get harder to swallow, and Parkinson's medicines matter a lot. Some come in other forms.

Some pills must not be crushed or split, because that changes how they work. A pharmacist can tell you which ones, and why.

Some people find a pill goes down more easily in a spoonful of soft food, like applesauce. A pharmacist can say which pills can go with food.

At a swallow test, you can ask to try your own pills, the way you take them at home.

Questions to ask your care team

• Would a swallow test with an X-ray or a small camera help me? What would it show?
• What are my options, and what does each one involve?
• What does the research say about swallowing therapy for Parkinson's?
• Should I time my meals around my medicine?
• How often should my swallow be checked again as things change?

When to get help

Get checked soon if you notice any of these. A doctor or SLP can look at what is going on.

You know your own body best. Bring what you notice to your care team, and decide together.

• Coughing or choking when you eat or drink.
• Food or pills that feel stuck.
• Losing weight without trying.
• Pneumonia or chest infections, especially if they come back.