Connections | Issue 1 2018

HEALTH
Highlight on Dysphagia
Practical advice for living with swallowing difficulties
Medications and swallowing – a tough act to swallow!
Taking medications to treat the symptoms of Parkinson’s disease can be extremely challenging for a variety of reasons.
Complicated prescription schedules involving a number of different medicines can be difficult to follow.
Additionally, side effects of these medicines see many people reluctant to continue with treatments.
Perhaps most importantly, though, are the practical obstacles that impact someone’s ability to physically take medications (e.g.
opening bottles, popping tablets from a blister pack).
Critically, though, swallowing difficulties can develop in over 80% of people with Parkinson’s, causing many to ‘trip at the final
hurdle’ when taking oral medications.
When any such challenges occur, seeking out assistance and solutions is paramount – and why not start at your local
pharmacy? Your pharmacist is a free first port-of-call for assistance and can help you start breaking down the
barriers.
If you are facing difficulty swallowing tablets, you can explore practical solutions to ensure you can still get benefit from your
medications. Important things to know:
• Medications and dosage forms vary in how they are absorbed and act in the body. Don’t go it alone! It is
critical to liaise with your pharmacist or doctor when solutions are being trialled.
• The most common method that people try to make swallowing easier is crushing tablets or opening
capsules – please do not break out the mortar and pestle without talking to your doctor or pharmacist! Many
medications are specifically formulated to release the drug at a certain point or rate in the digestive system
(e.g. Madopar HBS®). Altering medications by crushing or opening them alters their absorption in the body, and you
won’t get the benefit!
• Your pharmacist or doctor may be able to advise you of a more suitable formulation of the medication (e.g.
dissolvable tablet or liquid). A speech pathologist can also make other suggestions to aid swallowing.
• Retail products made to help in swallowing medications are also available (e.g. Gloup®) – again, chat to
your doctor or pharmacist before using these products as these are only recommended on a case by case basis.
What should I do if I think I have a swallowing problem?
Swallowing difficulties (called dysphagia) in Parkinson’s are extremely common and can be one of the earliest
symptoms. Initially, the swallowing symptoms might cause people with Parkinson’s to cough and clear their throat during
meals or when drinking. While this might seem like something that you can ‘put up with’, coughing when
eating and drinking can be a sign that food and drink is going down the wrong way.
If you notice you or your loved one has any of the following symptoms, you may have dysphagia:
• Coughing, choking or throat clearing during and after eating and drinking
• Feeling like food is getting stuck in the throat
• Noticing food still in the mouth after meals
• Avoiding certain foods because they are difficult to swallow
• Taking more than 30 minutes to finish a meal
• Weight loss without a cause
• Frequent chest infections with no known cause
If untreated, dysphagia can cause chest infections (e.g. pneumonia), malnutrition and dehydration, weight loss, discomfort
during meals and in serious cases, death. Dysphagia is a serious problem and should not be left untreated.
If you think you or someone you know has dysphagia, you should:
• Talk to your GP and ask for a referral to see a speech pathologist – there are a range of public and private options in
Queensland for people with Parkinson’s disease.
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Parkinson’s Queensland Inc.