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Dysphagia


What is Dysphagia?

Dysphagia is the medical term used to describe difficulty swallowing food and/or drinks. It may occur if there is decreased sensation, strength or control of the muscles of the mouth or throat.

What causes Dysphagia?

A swallowing problem may arise as a side effect of many conditions, such as:


What do we do?

Speech and Language Therapists assess how well a person's swallow is working by looking at the muscles involved in the swallow process. This is done simply by asking a person to follow some basic instructions to look at oral movements (e.g. stick your tongue out) and also involves the person having something to eat and drink.

Description of service

The majority of assessments take place in the outpatient clinics in the Speech & Language therapy department. The appointment can last approximately 40 minutes depending on the nature of the dysphagia.

If a more detailed assessment is required then a person may be referred on for a videofluoroscopy.

Home visits are arranged for residential and nursing home residents. Also if it is difficult for people to attend the hospital due to mobility issues, then a home visit can be arranged through discussion with the department.

Inpatients within York Hospital, Selby Hospital and Community Reablement Units for the Elderly are seen directly on the wards.


How do you access us?

Inpatient Referrals: Wards refer patients with difficulties directly to the department and they are seen for an initial assessment within 2 working days of receipt of the referral (Royal College of Speech & Language Therapists Guidelines).

Outpatient Referrals: These are made by GPs, Consultants or Specialist Neurology Nurses. Once a referral is received, it is triaged and an appointment is arranged.

For further information, please contact the department on 01904 725768 or email our dysphagia specialist Helena Perry: helena.perry@york.nhs.uk


What difficulties can occur?

If the muscles used for swallowing are affected, one or more of the following may occur:

  • Difficulty biting or chewing

  • Difficulty moving and controlling food in the mouth

  • Difficulty keeping food in the mouth

  • Decreased awareness/sensation of food in the mouth which may fall into the throat

  • Food or liquid getting stuck in the throat

  • Food or liquid going into the trachea causing coughing or choking

  • Food or liquid going into the lungs causing a chest infection or pneumonia


How are swallowing problems managed?

A person's swallow is assessed to find which muscles of the swallow have been affected and how severe the problem is. Some people with dysphagia can eat and drink but may need the texture of their food and drink to be modified. As the person's condition changes, their diet is gradually modified by the Speech and Language Therapist.

If the swallowing problem is very severe and most food and liquid is likely to go into the lungs, the person may not be allowed to have food or drink at all. If this situation persists for a few days, the person may need to be fed through a tube going from the nose down to the stomach (called a nasogastric tube/NG tube) or by a tube that goes directly into the stomach (called a PEG).

What are thickened drinks?

A thickening powder is added to liquids in order to change the consistency. This is done as thickened drinks are easier to control in the mouth and do not spill down as quickly into the throat as do normal/thin drinks.

Pureed diet:

Pureed food consistency is recommended when the tongue, mouth or throat muscles are too weak to chew and swallow normal food.

Soft diet:

Soft food requires some chewing, but normal muscle strength and teeth are not necessary. This means that you can eat more, more easily.

For further advice regarding modified diets and fluids, please contact the Speech & Language Therapy Department on 01904 725768.


How long will the swallowing problems last?

Swallowing problems and their progression vary greatly depending on the cause of the dysphagia. Some individuals may require long term use of alternative feeding or a modified diet. In other cases, their dysphagia may completely resolve. It is best to consult a Speech and Language Therapist regarding this.


Is there anything others can do?

  • Meals should be supervised or monitored

  • During meals, the person should be sitting supported; in an upright position. The person should eat slowly, one mouthful at a time. Making sure that each mouthful is swallowed before the next one is taken

  • Minimise distractions

  • The person should sit up for half an hour after meals

  • The Speech and Language Therapist may have given specific instructions regarding feeding. Please follow these very carefully.

  • If the person is having obvious difficulty, contact the Speech and Language Therapist

  • Ensure good oral hygiene - the person's mouth should be clear of all food after meals and teeth should be brushed regularly.


Useful Information


To return to the Speech and Language Therapy home page click here.

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Visiting cancelled

Due to the increasing number of cases of coronavirus across the UK, York Teaching Hospital NHS Foundation Trust has made the decision to cancel all visiting to all its hospital sites in order to ensure the safety of patients and staff.

There are three exemptions to the ruling which are for one parent of a sick child under 18, for the partner of a woman giving birth and end of life patients at the discretion of the ward sister.

We would ask people to respect this decision and to treat our staff, who will be enforcing the visiting restrictions, with courtesy and respect.  For more information visit our website.


Outpatient appointments

We know that NHS services will come under intense pressure as the coronavirus spreads, and as a Trust we need to redirect staff, free up staff for refresher training and carry out any works as necessary, so we are able to maximise capacity for patients for when the number of infections peak.  We also need to reduce the number of people coming into our hospitals to protect our patients, as well as keeping our staff safe, well and able to come into work.

To do this, with effect from Tuesday 24 March 2020, along with other trusts in the Humber Coast and Vale partnerships, we have made the collective decision to suspend all non-urgent routine outpatient appointments for at least three months.  Urgent and emergency cases and cancer appointments will be carrying on as normal.

These are unprecedented times and we thank you for your understanding.  We know many people waiting for treatment will be disappointed or worried but please not contact the hospital as we will be contacting everyone directly affected in the coming days and weeks.

If you do not receive a letter or a phone call from the hospital, please turn up for your scheduled appointment as normal unless you have symptoms of coronavirus, a cold, flu or norovirus in which case you should contact us to cancel your appointment by clicking here.


Coronavirus (COVID-19)

If you have symptoms associated with coronavirus including a new continuous cough and a high temperature, you are advised to stay at home for 7 days.

Please do not book a GP appointment or attend your GP practice.

If you live with other people, they should stay at home for at least 14 days, to avoid spreading the infection outside the home.  After 14 days, anyone you live with who does not have symptoms can return to their normal routine.

But, if anyone in your home gets symptoms, they should stay at home for 7 days from the day their symptoms start. Even if it means they're at home for longer than 14 days. The most up-to-date public guidance is always online at www.nhs.uk/coronavirus

If your symptoms are serious, or get worse, NHS 111 has an online coronavirus service that can tell you if you need further medical help and advise you what to do.  Only call 111 direct if you are advised to do so by the online service or you cannot go online.