Living with multiple sclerosis (MS) can make everyday activities and actions, such as swallowing, more difficult. A person living with MS may find that they start to have trouble swallowing food or drinks, which is known as dysphagia.
People who experience dysphagia can take some steps to manage the condition at home. Healthcare professionals can help a person develop strategies for safer eating and swallowing.
This article discusses MS-related dysphagia in more detail, including the possible causes, side effects, and treatment of the condition.
MS is a chronic inflammatory disease that affects the central nervous system.
Dysphagia is the medical term for having trouble or difficulty swallowing food or beverages. According to the National Multiple Sclerosis (MS) Society, dysphagia can occur frequently in people living with MS because the disease impairs nerve control of the muscles in the jaw, tongue, and throat that are responsible for chewing and swallowing. The effects of the disease on the brain can cause weakness and coordination issues.
A 2018 study estimated that the general prevalence of dysphagia in those living with MS was
If a person living with MS has trouble swallowing, they should talk with their doctor. Without treatment, dysphagia can lead to more serious problems, such as choking. In some cases, it can result in aspiration, where food, saliva, or stomach acid gets into a person’s lungs.
Why it happens
Swallowing is a complicated process involving both voluntary and involuntary muscles. As MS affects the brain, it can impair the movement of both the voluntary and involuntary muscles.
The Multiple Sclerosis Association of America (MSAA) notes that swallowing involves several sets of muscles. When a person swallows, the pharynx moves food toward the throat. The muscles of the larynx (voice box) cover the upper portion of the trachea, which is the pipe that connects to the lungs, so that food cannot go down it. Instead, the food travels into the esophagus, which leads to the stomach.
If MS affects the part of the brain that controls these muscles, it can lead to problems relating to the movement of the larynx, esophagus, or both.
Causes
The authors of a
- lesions in the corticobulbar tract, which plays several roles in the body, including carrying messages to the facial muscles and controlling chewing
- paresis (weakness or impairment) of cranial nerves
- cognitive dysfunctions
- disorders of the cerebellum and brain stem
Regardless of the underlying cause, dysphagia can affect any part of the swallowing process in the mouth, pharynx, and esophagus.
The Multiple Sclerosis (MS) Trust further clarifies that MS can cause swallowing issues by:
- altering the way a person feels food in their mouth
- causing muscles in the mouth and throat to become out of sync
- weakening the muscles in the mouth and throat
Symptoms
The symptoms of dysphagia can range from mild to severe. According to the National MS Society, a person with dysphagia may experience the following:
- a feeling of food being stuck in the throat
- unusual sensations in the mouth and throat
- difficulty chewing and swallowing
- a choking sensation when eating or drinking
- frequent throat clearing while drinking or eating
- dehydration
- airway obstruction
- aspiration pneumonia
- malnutrition
Given the prevalence of dysphagia among those living with MS, learning how to manage swallowing issues is important.
The MSAA recommends that people experiencing difficulty swallowing change the consistency and size of some of the solid foods that they consume. For instance, a person can cook food for longer so that it is softer, take smaller bites, and avoid foods that are dry or difficult to chew.
Tips for managing swallowing difficulties
The MS Trust suggests that people with swallowing issues due to MS take the following steps:
- cutting food into smaller pieces and taking smaller mouthfuls
- chewing well before swallowing
- slowing down while eating meals
- sitting upright in a straight back chair during meals
- avoiding foods that may cause worsening symptoms, which can vary from person to person
- concentrating on swallowing
- taking sips of a drink between mouthfuls of food to keep the food and the throat moistened
In addition, the Multiple Sclerosis Foundation recommends:
- looking straight ahead when eating, with the chin slightly tucked, to help close the airway and send food to the right location
- learning how to perform the Heimlich maneuver on oneself and teaching family members how to do it as well
- refraining from talking with food in the mouth
However, early detection and treatment can help. A speech-language pathologist typically tests for and diagnoses dysphagia. A person living with MS who experiences symptoms related to swallowing issues should talk with their doctor as soon as possible to undergo tests.
Common courses of treatment include:
- developing strategies for safer eating and swallowing
- making dietary changes
- practicing exercises or stimulation to help encourage swallowing
Dysphagia occurs often in people living with MS. MS can affect the strength and coordination of the muscles in the mouth and throat. As a result, a person may feel as though they have something stuck in their throat, or they may choke on their food or drink.
Treatment options often involve lifestyle modifications that help a person avoid issues with swallowing food. A person should talk with their doctor if they are living with MS and are experiencing difficulties with swallowing food or drink.