As muscles in the tongue, and jaw become weak, it can become difficult to move food around in the mouth, clear out the sides of the mouth, or to chew harder foods like apples or chewy meat. Drinks may spill from the mouth a little due to lip weakness. Weak muscles in the throat can cause food to stick in the throat during swallowing. Food and drink may sometimes go down ‘the wrong way’, causing coughing. If your cough is also weak, you may have difficulty preventing small amounts of food and drink getting into you lungs (aspiration). This can lead to chest infections/pneumonia.
Your speech and language therapist can advise on specific strategies to help make swallowing more comfortable and safe. It may also be useful to modify the texture of foods – soft or pureed foods or ‘thicker’ drinks can be easier to swallow.
The following is some general advice:
- Sit upright, facing forwards, chin level or down slightly
- Avoid distractions, e.g. turn off the TV and try not to talk during a meal
- Take small mouthfuls of food
- Take your time, don’t rush
- Chew carefully and finish each mouthful before you take the next
- When drinking take single sips of fluids slowly, rather than gulping mouthfuls
- Avoid mixing fluids and solids e.g. soup with bits in, cornflakes with milk
- Avoid dry crumbly foods, moist foods may be easier
- Sit upright for 20 minutes after eating and drinking
Swallowing may become so difficult that you no longer take pleasure from eating. Some people decide to have a procedure called a percutaneous endoscopic gastrostomy (PEG for short) where a tube is inserted into the stomach and special food can go directly to the stomach. Some people that choose PEG feeding continue to eat and drink small amounts in the normal way, with extra food and fluids taken via their PEG. This can take the pressure off needing to eat and drink large quantities.
The speech and language therapist, occupational therapist, physiotherapist, dietician, GP and neurologist are available to support and advise you on particular aspects of your condition.
Where can I find more information?
MND Connect (Motor Neurone Disease Association)
Telephone: 08457 626262
Email: mndconnect@mndassociation.org