Difficulty Swallowing

Difficulty swallowing - dysphagia - means food or drink is slow, uncomfortable or feels stuck going down your food pipe. It is usually caused by another health condition. The NHS advises having a swallowing problem looked at urgently rather than waiting. Oesophageal cancer is one of the conditions that can cause it, accounting for 2% of all new cancer cases in the UK (2019, 2021-2022).

Book online now

No items found.

Difficulty Swallowing

Overview

What Is Difficulty Swallowing?

Dysphagia is the clinical name for difficulty swallowing. Some people have problems swallowing certain foods or drinks, while others cannot swallow at all [1]. It can happen at any age, and it is usually a sign of something else going on rather than a condition in its own right [1].

Signs of dysphagia include [1]:

coughing or choking when eating or drinking
bringing food back up, sometimes through the nose
a feeling that food is stuck in your throat or chest
a gurgly, wet-sounding voice when eating or drinking

You may also drool and have problems chewing your food [1].

When Should You Seek Assessment for Difficulty Swallowing?

Use the two tiers below as a general guide, not a diagnosis.

Call 999 now if:

you are having severe difficulty breathing - you are gasping, choking or not able to get words out [3]

LivingCare is a specialist outpatient service and is not an emergency care facility. If your symptoms are sudden or severe, call 999.

Ask for an urgent GP appointment or get help from NHS 111 if you [1]:

have difficulty swallowing
cough or choke while eating or drinking
feel like something's stuck in the throat after eating
have a wet, gurgly voice after eating or drinking
are short of breath after eating or drinking
get lots of chest infections
are losing weight because you are not able to eat or swallow properly

You can call 111 or get help from 111 online [1]. Note the tier: the NHS treats a swallowing problem as urgent rather than routine, which is stronger than its advice on most digestive symptoms.

NICE guidance is direct on the same point. It recommends referral through the suspected cancer pathway for anyone with dysphagia, whatever their age, and for people aged 55 and over who have weight loss together with upper abdominal pain, reflux or indigestion [4]. NICE defines that pathway as a diagnosis or ruling out of cancer within 28 days of the urgent referral [4]. That is a standard for how quickly the question gets answered - not a statement about what the answer will be.

What Might Be Causing My Difficulty Swallowing?

Dysphagia is usually caused by another health condition and can happen at any age [1]. You may be more likely to have it if you [1]:

have heartburn and acid reflux, particularly gastro-oesophageal reflux disease (GORD) - long-standing reflux
have a condition that affects the nervous system or brain, such as cerebral palsy, a stroke, dementia or multiple sclerosis
have problems with your breathing caused by conditions like chronic obstructive pulmonary disease (COPD)
take some medicines, such as antipsychotics
have cancer, such as mouth cancer or oesophageal cancer
have some specific inflammatory conditions of your food pipe, especially if you have an allergy or raised eosinophil counts

Two of those overlap with symptoms covered elsewhere on this site: Heartburn and Acid Reflux, and Unexplained Weight Loss, which NICE names alongside dysphagia in the referral criteria above [4]. Over time, dysphagia itself can cause weight loss, dehydration and repeated chest infections [1] - which is part of why it is not a symptom to sit on.

Digestive symptoms are easy to live with for months and quick to look at. Our article on the gut symptoms you shouldn't ignore covers the others.

How Difficulty Swallowing Is Assessed

A GP will examine you and may refer you to a specialist for further tests [1]. Privately, the route is the same - it just starts sooner.

So, a visit to your GP or gastroenterology consultation is the starting point - the specialist reviews your symptoms and arranges only the tests they call for. For a swallowing problem, that usually means a Gastroscopy, which examines the food pipe and stomach. Nothing is booked before the specialist has decided it is needed.

Some people are also referred to a speech and language therapist or a dietitian for advice about swallowing and diet [1]; that is not part of LivingCare's gastroenterology service.

You can book a Gastroenterology Consultation directly. Self-pay, with no GP referral needed. If you are using medical insurance, your insurer may ask for a GP referral letter. You can also read more about our wider Gastroenterology service.