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NHS Choices - Complications of dysphagia

(29/01/2015)

The main complication of dysphagia is coughing and choking, which can lead to pneumonia.

Coughing and choking

If you have dysphagia, there's a risk of food, drink or saliva going down the "wrong way". It can block your airway, making it difficult to breathe and causing you to cough or choke.

For more information and advice, see What should I do if someone is choking?.

If you have dysphagia, you may also develop a fear of choking. However, it's very important you don't avoid eating and drinking, as it could cause dehydration and malnutrition.

If you often choke on your food because of dysphagia, you may also be at an increased risk of developing a condition called aspiration pneumonia.

Aspiration pneumonia

Aspiration pneumonia is a chest infection that can develop after accidentally inhaling something, such as a small piece of food. It causes irritation in the lungs, or damages them. Older people are particularly at risk of developing aspiration pneumonia.

The symptoms of aspiration pneumonia include:

  • a cough – this may be a dry cough, or you may produce phlegm that's yellow, green, brown, or bloodstained
  • a high temperature of 38C (100.4F) or over
  • chest pain
  • difficulty breathing – your breathing may be rapid and shallow and you may feel breathless, even at rest

Contact your treatment team immediately if you're being treated for dysphagia and you develop these symptoms. If this isn't possible, contact your local out-of-hours service or call NHS 111.

Symptoms of aspiration pneumonia can range from mild to severe, and it is usually treated with antibiotics. Severe cases will require hospital admission and treatment with intravenous antibiotics (through a drip). Read more about treating pneumonia.

In particularly old or frail people, there's a chance the infection could lead to their lungs becoming filled with fluid, preventing them working properly. This is known as acute respiratory distress syndrome (ARDS).

Your chances of developing pneumonia as a result of dysphagia are higher if you have a weakened immune system, chronic obstructive pulmonary disease (COPD), or if your oral and dental hygiene is poor.

Dysphagia in children

If children with long-term dysphagia aren't eating enough, they may not get the essential nutrients they need for physical and mental development.

Children who have difficulty eating may also find meal times stressful, which may lead to behavioural problems.