COPD and swallowing - Lung Foundation

Better Living with Chronic Obstructive Pulmonary Disease A Patient GuideSwallowing problems (called dysphagia) can occurbecause the need for oxygen will always overrulethe need to protect the lungs from food or fl uids.What are the consequencesof a swallowing problem?Swallowing problems and aspirationIf breathing timing is even slightly changed duringswallowing, the airway may not be fully closed andfood or fl uid may be breathed into the lungs. Thisis called aspiration and may lead to chest infectionsor pneumonia.Normally, when food or fl uid ‘goes down the wrongway’ (aspirated), you automatically cough up thefood or drink. As people who have COPD often havea weakened cough refl ex, they may not be able toclear all the food or fl uid out of their breathing tubesor airways.Aspiration is a symptom of swallowing problems. Theextent of the swallowing problems can change overtime, and may depend on how bad your breathingproblems are at the time (and other medical factors).As many as 20% to 40% of people who have COPDexperience aspiration (particularly during a fl are up).Swallowing problems are often under-diagnosed inpeople who have COPD because silent aspirationcan be diffi cult to detect.Swallowing problems and nutritionAs you are using more energy to maintain yourbreathing during chewing and swallowing, eatingand drinking can become more tiring. As a result,you may take longer to complete your meals andyou may eat and drink less. Eating and drinkingless could cause you to miss out on importantnutrients and lose weight.How can you tell if you areexperiencing swallowing problems?Read the following two lists of the common signs ofswallowing problems. Tick the box next to any signthat you experience when eating and drinking:List 1❑ Coughing or choking after swallowingfood or drinks.❑ Increased shortness of breath during meals.❑ Wet or ‘gurgly’ voice after swallowing.❑ Feeling like food is getting stuck in the throat.❑ Diffi culty chewing foods.❑ Taking longer to start a swallow.List 2❑ Food or drink going into your nose.❑ Food or drink remaining in the mouthafter swallowing.❑ Refl ux or regurgitation.❑ Taking much longer to fi nish meals.❑ Getting more fatigued after eating and drinking.❑ Unexplained weight loss.❑ Unexplained temperatures or changes insputum colour.If you ticked two to three items (particularly those inList 1), or are concerned about your swallowing, askyour GP (or respiratory specialist) to refer you to aspeech pathologist who can assess your swallowing.69Chapter 16: Chronic obstructive pulmonary disease and swallowing