Swallowing problems

Cancer and its treatments can sometimes cause trouble with swallowing. If you’re having problems swallowing, try eating soft or liquid foods. You may be able to swallow thick fluids more easily than thin liquids. If you’re unable to eat enough regular foods to meet your nutritional needs, drink high-calorie and high-protein liquids.

Your doctor may refer you to a speech therapist. This is an expert health professional who can teach you how to swallow better and how to decrease coughing and choking when you eat and drink.

What to do

  • Follow your speech therapist’s instructions for any special eating techniques.
  • Call your cancer care team right away if you cough or choke while eating, especially if you have developed a fever.
  • Eat small, frequent meals.
  • Use canned liquid nutritional supplements if you’re unable to eat enough food to meet your needs.
  • Chop or puree your food in a blender or food processor.
  • Drink 6 to 8 cups of fluid each day, and thicken the fluid to the consistency that’s easiest for you to swallow.
  • Try these thickening products:
    Gelatin: Use to help soften cakes, cookies, crackers, sandwiches, pureed fruits, and other cold food. Mix 1 tablespoon unflavored gelatin in 2 cups hot liquid until dissolved; pour over food. Allow food to sit until saturated.
    Tapioca, flour, and cornstarch: Use to thicken liquids. Note that these must be cooked before using.
    Commercial thickeners: Follow label instructions, and use to adjust a liquid’s thickness.
    Pureed vegetables and instant potatoes: Use in soups. Note that these change the food’s flavor.
    Baby rice cereal: Use to make a very thick product.

  • If thin liquids are recommended for you, try these: coffee, tea, soft drinks, liquid nutritional supplements, Italian ice, sherbet, broth, and thin cream-based soups.
  • If thick liquids are recommended for you, try these: buttermilk, eggnog, milk shakes, yogurt shakes, and ice cream.

What to eat when you have trouble swallowing (puréed and thick-liquid diet)+

  Puréed thick-liquid diet Mechanical soft diet
Protein

    Thickened milk, yogurt without fruit, cottage cheese, sour cream

    Casseroles

    Soft-scrambled eggs

    Puréed meat, poultry, and fish

    Milk, yogurt, cheeses, sour cream

    All eggs

    Ground meats and ground-meat casseroles, fish, sandwiches made with ground meats or spreads

Breads, cereals, pasta, and rice

Slurry^ of cooked cereals like Cream of Wheat and Cream of Rice

    Soft breads

    Graham crackers, cookies

    Soft cold cereals in milk

    Pancakes, waffles

    Pasta, rice

Fruits and vegetables

    Puréed fruit and vegetables without seeds and skins

    Mashed potatoes

    Bananas

    Canned fruit

    Soft, well-cooked, or puréed vegetables

Drinks, desserts, and other foods

    Thickened juices and nectars

    Thick milk shakes

    Thickened broths and cream soups

    Custards, puddings

    Slurried^ cakes and cookies

    Syrups, honey, butter, margarine

    Spices as tolerated

    All beverages

    Soft desserts that don’t require much chewing (like ice cream, sherbet, flavored gelatin, pudding, custard), soft cakes and cookies

    Syrups, honey, butter, margarine

    Spices

^A slurry is a thin paste of water and cereal or flour that can be stirred into hot preparations as a thickener. A slurry on top of bread or cake makes it moist and easier to swallow.

+ Adapted from Grant BL, Bloch AS, Hamilton KK, Thomson CA. American Cancer Society Complete Guide to Nutrition for Cancer Survivors, 2nd Edition. Atlanta, GA: American Cancer Society; 2010.

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master’s-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Last Medical Review: July 15, 2015 Last Revised: July 15, 2015

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