Swallowing problems can occur in any age group, but are more prevalent with elderly patients.
There can be a number of reasons that someone is having a swallowing problem (commonly called dysphagia).
There are signs that someone is having a swallowing problem and there are steps that can be taken to make the patient as safe as possible until they can be seen by a physician.
Swallowing is divided into stages:

1. The oral preparation phase occurs prior to the initiation of a swallow when the food is pulled together by the tongue and manipulated around the inside of the mouth to be chewed.
   The tongue also pulls together liquid in the mouth and holds it carefully prior to the beginning of the actual swallow.
   
2. During the oral phase of the swallow the tongue squeezes the food against the hard palate and the swallow begins.
   
3. The pharyngeal phase of the swallow begins with the triggering of the swallow reflex.
   The time it takes for the food or liquid to move from the point at which the reflex is triggered and the food or liquid moves into the esophagus is generally about one second long.
   
4. The time (about 8 to 20 seconds) that it takes for the food or liquid to move from the esophagus into the stomach is called the esophageal phase.
   

Signs of a swallowing problem can include:

• drooling
• coughing or choking while eating
• holding food in the mouth
• pocketing food in the cheeks
• frequent throat clearing
• excessive chewing of food
• spitting food out
• decreased food consumption
• vomiting after meals
• a wet, gurgly voice
• a strangled voice
• complaints of something being caught in the throat
• increased body temperature approximately 30 minutes after a meal
• avoidance of certain foods
• frequent respiratory infections, including pneumonia
• difficulty breathing after eating
• a runny nose

If you suspect a swallowing problem based on any of these symptoms (or a combination of symptoms), it should be reported to a physician immediately so that an appropriate diagnosis can be made.
This will allow the appropriate treatment to be provided to the patient.
As soon as a swallowing problem is detected, there are steps that can be taken to make the patient as safe as possible until a swallowing evaluation can be completed:

• Insure that patient is sitting up for all meals and remains in an upright position for at least 30 minutes after the meal
• Be sure that good oral hygiene is being provided if the patient is not able to do this independently
• Make sure that the patient finishes each bite before taking another bite
• Encourage small bites and sips of food at a slower rate to allow extra time for chewing and swallowing
• Check the patient's mouth for food after each meal is completed to be