13 ways to decrease swallowing problems in Parkinson’s disease

Many people with Parkinson's disease experience problems with swallowing food, liquid and medications

Many people with Parkinson’s disease experience problems with swallowing food, liquid and medications

People with Parkinson’s disease may notice changes with swallowing, especially as the disease progresses. Speech-language pathologists evaluate swallowing (in addition to speech and communication skills) and provide treatment and suggestions to facilitate swallowing.

Here is some information you may find helpful.

Basic swallowing suggestions

  1. Sit upright. Bring the liquid or solid up to mouth; don’t bend your head down to the table.
  2. Start meals by taking small sip of water to moisten mouth.
  3. Take smaller bites and small sips.
  4. Swallow everything in your mouth prior to the next bite or sip.
  5. Avoid tipping head back when swallowing.
  6. Alternate swallows of liquids and solids.
  7. Eat and drink more slowly.
  8. Swallow again or swallow twice if needed.
  9. Do not try to talk and swallow at the same time.
  10. Time your medication to get maximum benefit during meals.
  11. Keep auditory and visual distractions (such as the radio, TV, conversations, etc.) to a minimum during meals.
  12. Sit upright for at least 30 minutes after eating to help prevent heartburn/reflux.
  13. Maintain good oral hygiene. Brush teeth after every meal.

Suggestions to assist with swallowing of medication

  • Swallow only one pill at a time with small sips of liquid.
  • Place the pill in the middle of your tongue.
  • Break the pill into smaller pieces or crush (if allowed for that medication).
  • Mix pill or pieces of pill with small amount of puree such as applesauce or yogurt.

Symptoms suggesting swallowing problems

  • Weight loss
  • Drooling
  • Inability to clear food from mouth
  • Change in voice after the swallow such as a gurgling, wet-sounding quality
  • Coughing, choking before during or after the swallow of liquids and/or solids
  • Choking on your own saliva
  • Difficulty swallowing medication

If you notice any of the above symptoms, ask your neurologist or primary care physician to refer you to speech-language pathology for an evaluation.

Note: Pain with swallowing, heartburn, GERD (gastric esophageal reflux disease) and/or a sticking sensation after the swallow—require medical assessment.

Next steps

Karen_KluinKaren Kluin, M.S., CCC, BC-ANCDS is a Board Certified and American Speech Language Hearing Association (ASHA)-certified speech-language pathologist at the University of Michigan. She is a senior supervisor in the Department of Speech Language Pathology and a Clinical Assistant Professor in the Department of Neurology. She has expertise in speech, language, cognitive communication and swallowing disorders in neurologic diseases, including Parkinson’s disease.


Clinical-Neurosciences-signature-verticalThe University of Michigan’s multidisciplinary clinical neuroscience team is made up of more than 70 nationally recognized neurologists, neurosurgeons and neuroanesthesiologists. Leading the way in brain, spine and nervous system care for close to 100 years; patients have access to services that can be found at only a handful of places; as well as innovative treatments with the latest research. Neurology and Neurosurgery at the University of Michigan Health System have been recognized by U.S. News & World Report numerous times for excellence in patient care.