What does this mean?
Swallowing happens as the base of the tongue, the floor of the mouth and the throat muscles fall into sequence within seconds. Inflammation or oedema building up in this area narrows the room those muscles have to move. You feel the difficulty while swallowing first, because the swallowing movement is what breaks down before the airway narrows. Difficulty swallowing is therefore treated as a warning that arrives ahead of any trouble with breathing.
What matters here is what you cannot swallow. Solid mouthfuls catching suggests a problem that has settled in over months and calls for a planned assessment. Struggling to swallow your own saliva, saliva pooling in your mouth and running from the corner of your lip, is an urgency of a completely different order. If a temperature, an inability to open your mouth, a tongue that looks pushed upwards, hardening under the jaw like a board, or a muffled voice have been added to that, the picture can move on within hours.
The causes sit across a wide range. An infection spreading from the lower back teeth can involve the floor of the mouth; sudden swelling caused by a medicine or an allergy can narrow things at the level of the tongue and the throat; in children enlarged tonsils can make swallowing hard; and where difficulty swallowing has lasted for months and is steadily getting worse, the throat and the gullet are examined separately. What they all share is that this symptom is not expected to settle on its own.
The cause of difficulty swallowing may be an infection spreading from the mouth, but it may equally be sudden swelling or another problem in the throat area, and the distinction rests largely on how quickly the symptom has set in.
Likely causes
What helps at home?
- Do not lie on your back. Sitting up, or leaning slightly forward, reduces the difficulty and is safer until you reach a clinician.
- Do not force swallowing while the swelling is there. Leave solid food and large mouthfuls of drink aside, because the risk of choking is real in this picture.
- Do not try to get by on left-over antibiotics. The hours lost here count for more than anything the medicine might add.
- Do not apply heat or massage to the swelling in your neck or under your jaw. Handling that area before it has been assessed is not the right move.
- If you cannot swallow your own saliva, or saliva is running from your mouth
- If you are struggling to breathe or there is a wheeze; call 112 in that case
- If the area under your jaw has hardened along with a temperature, or you feel your tongue being pushed upwards
- If your speech has changed as though something were in your mouth, or your voice has become muffled
- If your lip, your tongue or your throat has started to swell within minutes
Frequently asked questions
- Are a stuck feeling in the throat and difficulty swallowing the same thing?
- They are not the same. Feeling as though something is stuck in your throat most often happens between meals and eases as you swallow a mouthful; nothing is actually catching. With difficulty swallowing, food or fluid really does fail to go down, swallowing is painful, and the complaint gets heavier over time. The second will not wait.
- Can a tooth infection cause difficulty swallowing?
- It can. The roots of the lower back teeth neighbour the floor of the mouth, and an infection spreading from there can push the tongue upwards, making swallowing hard first and breathing hard at a later stage. That is why, when difficulty swallowing is added to a swelling coming from a tooth, the assessment moves from dental surroundings to hospital surroundings.
- Should I go to the emergency department, or can it wait until morning?
- If you cannot swallow your saliva, you have a temperature, or the area under your jaw is hardening fast, do not wait for the morning; and if you are also struggling to breathe, call 112. Difficulty that has lasted for months, shows itself only with solid food and is not getting worse quickly is not an emergency, but it does need a planned assessment.
This content is for general information and does not replace an in-person examination. Symptoms overlap between conditions, and a diagnosis can only be made clinically.