Eating and swallowing difficulties
Some people with Parkinson’s may find they have problems when eating and swallowing.
If you find it difficult to swallow, you may:
- cough when eating or drinking
- find it difficult to keep food or drink in your mouth
- find it hard to start to swallow so that food goes round and round in your mouth
- find it takes longer to chew your food
- have difficulty opening your mouth.
There are 4 main problems that are linked to swallowing:
- silent aspiration, which is when food or liquid from the mouth enters the lungs rather than the stomach, without any of the usual signs of coughing or choking. This can lead to a chest infection, known as aspiration pneumonia
- not eating enough to maintain good general health (known as malnutrition)
- not drinking enough, which can lead to other medical issues, such as constipation or dehydration
- a rarer occurrence is food blocking the airway and stopping your breathing (known as asphyxiation).
It's very important to talk to your GP as soon as you can if you have problems with swallowing, as they may refer you to specialists who can offer help.
A speech and language therapist, who works with people with swallowing problems, can offer information and suggest strategies to overcome some of the challenges you are experiencing.
In most areas, you will be able to contact a speech and language therapist through the speech and language therapy department at your local hospital. You may also be referred by your GP, specialist or Parkinson’s nurse. Find out about speech and language therapy.
Before an assessment, you may find it helpful to keep a diary of when problems with swallowing happen and which foods you find most difficult to eat. Learn more about keeping a diary.
Make sure you are comfortable at meal times. The following suggestions may help make it easier to eat:
- Take your time and eat in a comfortable, quiet place.
- If you feel you are taking too long and food is getting cold, consider eating smaller, more frequent meals and snacks, or food that is easier to eat.
- You can buy heated plates to keep food warm for longer or consider serving smaller portions so that a second portion can be kept warm or reheated if it’s safe to do so.
- Posture is important to trigger a good swallow. Try eating sitting upright in your chair.
- Try planning your meals for when your medication is working. Avoid trying to eat large meals when you are 'off'.
- If you wear dentures try to ensure they fit comfortably. Ask for a review by your dentist if you are concerned.
- Try to eat when you are less tired, this may mean moving your main meal to lunchtime rather than in the evening.
Should I try a different diet?
You may find certain foods difficult to chew or swallow.
If swallowing is becoming difficult, seek advice from a speech and language therapist, via your GP or a registered dietitian.
They may suggest changing the texture of the food you eat. For example, food that is soft and bite-sized, food that is minced and moist or food that has been pureed.
Semi-solid foods are usually easier to swallow than foods with mixed textures or very hard or dry foods.
A dietitian can then advise you on the type of foods that may be available in these forms so you can eat a balanced diet.
You may find the following helpful:
- Avoid hard, dry or crumbly foods.
- Meat that is tough or chewy can be difficult to swallow. Try using a gravy or sauce, chop meat up and consider different cooking methods, such as casseroling, as this makes meat more tender.
- Having a drink with your meal makes chewing and swallowing easier.
- Good posture and a comfortable position while eating will help with swallowing.
- Try taking smaller mouthfuls.
Difficulties with fluids
Sometimes people with Parkinson's have problems swallowing fluids.
Following an assessment, a speech and language therapist may suggest adding thickening agents to drinks.
These are available on prescription from your GP. Your dietitian can suggest fluids that thicken well to help maximise your fluid intake.
Tube feeding
If swallowing becomes very difficult or you’re not able to eat enough to maintain a healthy weight, your specialist, Parkinson’s nurse, speech and language therapist, or dietitian may suggest you consider tube feeding.
Find out more about eating, swallowing and saliva control in Parkinson’s, and about tube feeding in advanced Parkinson's.
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Diet and Parkinson's (PDF, 5.1MB)
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Managing swallowing problems in Parkinson's
"Our aim is to use your expertise about your condition and our expertise on the swallowing mechanism to work together and find solutions to help you."
If you have Parkinson’s, you may experience swallowing problems. Here, Nic Vasselin, an NHS speech and language therapist, tells us more about these issues and how they can be managed.
Next update due 2026
If you'd like to find out more about how we put our information together, including references and the sources of evidence we use, please contact us at [email protected]