Oropharyngeal Dysphagia

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Duke specialists use the latest diagnostic and treatment advances to treat people who have difficulty swallowing, a condition known as dysphagia.

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About Oropharyngeal Dysphagia

Swallowing disorders can make it difficult for you to drink liquids without choking, or can cause you to feel like food is stuck in your throat. You may experience frequent coughing or gagging while eating. Swallowing problems can lead to:

  • Aspiration pneumonia (an inflammation of your lungs and bronchial tubes caused by a foreign object)
  • Upper respiratory infections
  • Weight loss
  • Painful swallowing

We have the expertise and resources to diagnose your condition and help you eat and drink more efficiently, with less fear of choking.

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

Diagnostic Tests for Oropharyngeal Dysphagia

Swallow Evaluation

During this assessment, we will discuss your medical history as it relates to dysphagia, ask questions about your symptoms, and observe you swallowing various foods and liquids to look for signs of swallowing difficulty.

Fiberoptic Endoscopic Evaluation of Swallowing

A flexible endoscope (a small camera with a light) is passed through your nose. It allows your provider to observe while you swallow dyed foods and liquids. You may be asked to try different swallowing positions so your provider can see how they impact your ability to swallow foods of different consistencies. 

Videofluoroscopic Swallow Study (VFSS) or Modified Barium Swallow (MBS)

A speech-language pathologist works with a radiologist to perform a radiographic evaluation of your swallowing function. Moving X-ray images of the mouth, throat, and esophagus are taken while you try different swallowing positions and consistencies of food and liquid mixed with barium.

Barium Swallow

A barium liquid is swallowed and travels the length of your esophagus. X-ray images show problems such as narrowed areas and other concerns, such as how food and liquid travel through your esophagus.

Oropharyngeal Dysphagia Treatments

Rehabilitative Swallowing Exercises

Swallowing is complex and requires coordination of muscles and nerves. A personalized program will be designed to strengthen and increase coordination of your swallowing muscles so you experience safer, more efficient swallowing.

Compensatory Swallowing Techniques

We teach you techniques to make eating easier and safer. Techniques can include swallowing liquids after solids to wash food down your throat or changing the position of your head and neck when eating. We may also recommend dietary changes, such as adding a thickening agent to make liquids easier to swallow.


Botulinum toxin, or Botox, can treat certain swallowing problems by relaxing the upper esophageal sphincter, a muscular valve between the esophagus and throat. 


Surgery may be recommended if a disorder, such as vocal cord paralysis, is present that impairs swallowing. 

Consistently Ranked Among the Nation’s Best Hospitals

Duke University Hospital is proud of our team and the exceptional care they provide. They are why we are once again recognized as the best hospital in North Carolina, and nationally ranked in 10 adult and 9 pediatric specialties by U.S. News & World Report for 2023–2024.

Why Choose Duke

Experts with Advanced Training
Depending on your needs, your medical team may include otolaryngologists -- ear, nose, and throat (ENT) doctors -- neurologists, gastroenterologists, head-and-neck surgeons, and speech-language pathologists who have advanced training in evaluating and treating swallowing disorders.

High-Level Evaluation and Treatment
All of our providers have advanced training in dysphagia, and several of our speech-language pathologists are board-certified in swallowing and swallowing disorders. Our knowledgeable therapists offer the very best level of care.

Personalized Swallow Therapy
Our speech-language pathologists use therapeutic exercises to target the cause of your swallowing problems. They teach you safer eating and drinking strategies, offer guidance on positional or other behavioral changes during meals, and suggest specific food choices if you experience difficulty with chewing, coughing, or choking while eating and drinking.

This page was medically reviewed on 03/29/2022 by