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Nutrition and daily life

Difficulty swallowing: safe, comfortable eating

Mouth and throat sores, infections and radiotherapy can make swallowing painful or hard. Sometimes food or drink "goes down the wrong way" and causes coughing. This section covers foods that make swallowing easier and the warning signs.

Last updated: ~1 min read
Three bowls: carrot, pea and potato.
Figure 1.Smooth purée — Difficulty swallowing: safe, comfortable eating

01Short answer

Choose soft, smooth, moist foods: purées, porridge, yogurt, eggs, soups. Moisten food with sauce or broth, cut it small and eat slowly. Sit upright and do not lie down for 30 minutes after eating. Tell your team about frequent coughing or choking while eating, a change in voice, a feeling of food sticking in the chest, or fever. If needed, a specialist can assess swallowing and suggest thickened drinks.

02Simple explanation

Smooth, moist food.

Small bites, slowly.

Sit upright.

Coughing or choking? Tell us.

03Scientific explanation

Dysphagia: aspiration (food entering the airway) raises pneumonia risk; swallowing assessment and texture-modified diets reduce it.

ESPEN: enough energy and protein matter for preventing weight and muscle loss in people with cancer, and nutritional status should be assessed regularly.

NCI: practical eating tips exist for treatment side effects such as nausea, taste changes and mouth sores.

04What happens in the body?

Textures

Purée, minced and moist, thickened fluids: a specialist chooses the level.

An upright chair with a cushion and a bowl.
Figure 2.Upright seating — Difficulty swallowing: safe, comfortable eating

Pain

Pain relief prescribed by your doctor before meals may help.

A spoon standing in a glass.
Figure 3.A thickened drink — Difficulty swallowing: safe, comfortable eating

Dietitian

If you are losing weight, have no appetite or need a special diet, ask to see the hospital dietitian.

Food safety

Food-safety rules for neutropenia (see “Handwashing: the simplest protection” and “Eggs and dairy: safe choices”) apply at every stage.

05Nutrition: four steps

Assess, swap the risky, cook safely, eat regularly.

Assess — Weight and appetite.1AssessWeight and appetite.
Swap — A safe choice.2SwapA safe choice.
Cook — Hot throughout.3CookHot throughout.
Eat regularly — Small portions.4Eat regularlySmall portions.
StrengthEnergy.
ProteinFor muscle.
SafetyFood rules.

06Key points at a glance

TopicIn brief
TexturesPurée, minced and moist, thickened fluids: a specialist chooses the level.
PainPain relief prescribed by your doctor before meals may help.
DietitianIf you are losing weight, have no appetite or need a special diet, ask to see the hospital dietitian.
Food safetyFood-safety rules for neutropenia (see “Handwashing: the simplest protection” and “Eggs and dairy: safe choices”) apply at every stage.

07Key terms

Dysphagia
Difficulty swallowing.
Aspiration
Food or fluid entering the airway.
Dietitian
A nutrition specialist.
Protein
A nutrient for repairing muscles and tissues.
Neutropenia
Low neutrophils.

08Key points

  • Smooth and moist.
  • Sit upright.
  • Report coughing.
  • A diet is not a treatment.
  • Talk to a dietitian.

09Frequently asked questions

Must everything be blended?

Texture is chosen for you; ask your team.

Cannot swallow tablets?

Do not crush them yourself; some must not be crushed. Ask a pharmacist.

Can a special diet cure leukemia?

No. Good nutrition helps you cope with treatment, but it does not cure.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. Must everything be blended?

  2. Cannot swallow tablets?

  3. Can a special diet cure leukemia?

My questions

12Sources

  1. IDDSI. Framework
  2. National Cancer Institute. Eating Hints: Before, During, and After Cancer Treatment
  3. ESPEN. ESPEN practical guideline: Clinical Nutrition in cancer (2021)
  4. Leukemia & Lymphoma Society. Food and Nutrition
  5. World Health Organization. Healthy diet fact sheet
  6. World Health Organization. Botulism fact sheet
  7. USDA Food Safety and Inspection Service. Shelf-Stable Food Safety
  8. NHS. Botulism
  9. European Food Safety Authority. Hepatitis A virus in frozen berries
  10. NHS. Probiotics
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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