Swallowing after a stroke

Why swallowing can change

A stroke can weaken muscles on one side of the mouth, face or throat. It can also dull feeling there.

Trouble swallowing is common early after a stroke. Many people see it ease in the first weeks, and others need longer.

When there is no cough

Usually, food or drink going into the airway makes you cough. After a stroke, feeling can be dulled, so there may be no cough.

That is why a swallow check matters, even when meals seem fine.

What you might notice

• Food or drink leaking from one side of the mouth.
• Food left in the cheek on the weaker side.
• Coughing or a wet voice after drinking.
• Chewing that takes a lot of effort.
• Chest infections or fevers.

What can help

Stroke groups describe three kinds of options. Each has trade-offs, and you can weigh them.

• Techniques for the moment, like a chin tuck or turning the head. An SLP can check which ones work for you.
• Exercises for the tongue, lips, jaw and throat, shown by an SLP who can track whether they help.
• Changing food textures or thickening drinks. These can feel safer, but can make meals less enjoyable.
• Sit upright to eat, and stay upright for a while after.
• Keep your mouth clean, especially on the weaker side.

For family at the table

• Stay nearby while they eat and drink.
• Keep the room calm, and let them set the pace.
• Offer small bites and sips, and give them time.
• Watch for coughing, a wet voice, or food left in the cheek.

Questions to ask your care team

• What did my swallow test show? Can I see the results?
• Which options fit me, and what does each involve?
• What does the research say about swallowing exercises with an SLP after stroke?
• When should my swallow be checked again?
• What should my family watch for at meals?

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.