Dysphagia, or difficulty swallowing, is a disorder that can be a symptom of many neurological health conditions, including multiple sclerosis (MS).

Dysphagia is a common issue in people with advanced MS due to problems with muscle and nerve control. Difficulty swallowing can happen when there is a loss of control in any of the muscles involved, including your mouth, tongue, throat, pharynx, or esophagus.

This can lead to choking, difficulty eating, pain, inadequate nutrition, and other health issues. This disorder can be improved with the care of your doctor and healthcare team.

Read on for information about this common condition in MS, what causes it, and what can help those who may be experiencing it.

MS is a chronic inflammatory disease of the central nervous system that hinders the flow of messages between the brain and the body. There are many common symptoms of MS, including fatigue, weakness, and changes in speech.

Another MS symptom is difficulty swallowing, which is an intricate process with more than 50 muscles and nerves involved. Also known as dysphagia, this disorder can be caused by any condition that hinders muscles and nerves needed in order to swallow, such as MS, Parkinson’s disease, or stroke.

It’s very common in people with MS. As many as one-third of people receive a diagnosis of these symptoms related to swallowing. This can include weak tongue or cheek muscles that make it harder to move food around in your mouth for chewing.

Trouble with swallowing is more common in the later stages of MS, but it can happen at any time. Like many common MS symptoms, dysphagia can get better with time but also worsen during a flare-up.

Difficulty drinking liquids, including choking or coughing, is among the first signs of dysphagia.

Other symptoms of dysphagia can range from mild to severe. In addition to difficulty swallowing, people with dysphagia in MS may have:

  • dry mouth
  • weaker tongue muscles
  • loss of some tongue movement
  • slower and less coordinated chewing
  • a delay in triggering the gulp reflex
  • numbness of their mouth and throat
  • frequent throat clearing
  • a feeling that food is stuck in their throat
  • a coughing or choking sensation when eating or drinking
  • drooling and the inability to control drool

For people with MS who are having trouble swallowing, it may be linked to problems with nerves in the brain (cranial nerve paresis), brainstem issues, or other cognitive dysfunctions.

Additionally, people with MS may have nerve damage that causes numbness in their mouth and throat. MS can weaken the voluntary and involuntary muscles that help with swallowing.

There are certain risk factors that make dysphagia more common in general if you have MS:

  • Nerve issues. People with MS who have nerve issues in their brain causing motor problems are more likely to have dysphagia.
  • Aging. If you’ve had MS for a long time, you may be more likely to have dysphagia. Older individuals may also be more likely to have dysphagia, according to this older 2009 study.
  • Medications. Some medications prescribed to manage MS symptoms can also cause dry mouth, worsening dysphagia symptoms.
  • Eating and drinking problems. People with MS can face challenges in eating food and drinking liquids. Eating dry or crumbly foods and not drinking enough water and other liquids to stay hydrated may worsen dysphagia symptoms.

Dysphagia can be more serious if you have MS because you have a higher risk of choking and aspiration, as liquids or food might enter your airway or lungs.

This is a major hazard because it can lead to other health issues, such as pneumonia. Dysphagia can lead to other complications, like malnutrition and dehydration.

There are several methods doctors use to help pinpoint dysphagia and treat this disorder in people with MS:

  • A doctor may have you eat or drink something to observe your symptoms.
  • You may have to fill out a specific questionnaire form and take clinical scan tests, such as a barium swallow. This imaging procedure is used to look at muscles and nerves used to eat and drink.
  • With the help of a scan, a doctor can identify which muscles are hindering your ability to chew or swallow.
  • If you have dysphagia, the doctor may also recommend that you contact a speech pathologist. A speech pathologist can recommend exercises to help you improve swallowing if you have dysphagia.
  • Changes in your diet and how you prepare food can help with eating or drinking. These include adding thickeners to food to make it easier to swallow.
  • Doctors may use medications, like botulinum injections, to help treat some people who have trouble swallowing food. In serious cases, a feeding tube or surgery may be necessary to help with dysphagia symptoms and complications.

If you have MS, let your doctor know right away if you experience difficulty swallowing, drinking, or chewing. Early treatment and management are important to help prevent complications.

Your healthcare team can help determine the best treatment, therapy, exercises, and food changes to best manage dysphagia.

Dysphagia, or difficulty swallowing, can happen in some people with MS and other conditions that affect the nerves and muscles. It can sometimes be a serious issue and cause complications.

If you have dysphagia, there are treatment options and resources to help you deal with this condition.