Multiple Sclerosis and Dysphagia

Multiple sclerosis (MS) is an inflammatory condition that affects the brain and the spinal cord. The inflammation leads to injury and dysfunction of these nerve cells, which can sometimes be seen on imaging and is referred to as an MS plaque. These plaques can occur throughout the brain and the spinal cord and lead to problems with movement, sensation, thinking and other brain and nerve functions. Swallowing is one of the functions that can be affected.

Swallowing is controlled by our brain and the nerves that come from our spinal cord. While problems swallowing (also called dysphagia) typically occur in the later stages of MS due to the accumulation of plaques, this can also occur at any point in the disease process. Fortunately, dysphagia from MS can be treated and improve, except in the most severe cases.

Managing Dysphagia Occurring with Multiple Sclerosis

There are some ways to manage dysphagia due to MS and improve swallowing. Follow these tips and consult with your doctor:

1. Regular oral care is important.

Decreased saliva and oral cavities can worsen your ability to chew and swallow. See a dentist and brush your teeth regularly, plus do what your dentist recommends to add moisture in your mouth. For example, using a small spray bottle to spritz or spray water into your mouth throughout the day can help prevent dry mouth, ulcerations, and swallowing discomfort.

2. Work with a speech therapist.

A speech therapist can help you strengthen your swallowing muscles and recognize signs of choking or aspiration.

3. Only eat and drink when fully awake and able to sit upright at a table without distractions.

While swallowing used to be almost as automatic as breathing, having dysphagia means swallowing now must be a more focused and intentional act. Without this intentional process, you are at a higher risk of choking on food that was not thoroughly chewed or was not the right consistency.

4. Take small bites and chew thoroughly. 

This will help prevent choking on food, which can become life threatening. Changing the consistency of your food to a softer texture may also help if you are having difficulty chewing.

5. Change the position of your head and neck while eating.

Doing this can help lessen the risk of choking by making the entrance to your airway smaller. A common method is the chin tuck posture. Immediately before swallowing your food, drop your chin to your chest and then swallow. This slows the passage of food to the esophagus to allow the windpipe to close. It also restricts the opening to the airway, helping to prevent choking.