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What is this information about?
This information is about how you can make it easier to eat so you get the nutrition you need if you find it difficult to swallow.
It explains:
- why you may find it difficult to swallow
- ways in which you can eat that can make it easier for you to swallow
- which foods are easier or harder to swallow
- tips on eating to help you to get the nutrition you need if you do not have much of an appetite or you have lost weight without meaning to.
Why have I been given this information?
You have been given this information because you find it difficult to swallow.
Following the advice in this information can:
- help you to cope with changes in how easy it is for you to swallow.
- help you get the nutrition you need to be as healthy as possible.
Why might I find it difficult to swallow?
If you:
- find it difficult to swallow
- feel that food is getting stuck in your ‘food pipe’ that connects your mouth to your stomach (your oesophagus or gullet)
this may be because:
- your oesophagus has narrowed
- the muscles which push food and liquid down into your stomach are not working as they should.
Your ability to swallow varies and everyone is different.
What tips for eating should I follow if I find it difficult to swallow?
Do
- sit up straight (at a table if you can) to eat
- take your time and eat slowly
- take small mouthfuls
- chew your food as much as possible
- have a drink with your meal
- avoid foods which are difficult to swallow until your swallowing improves
- spit out any foods which you think you may not be able to swallow.
Some solid foods, if you chew them well, will be easier to swallow than others. For example, cheese will ‘melt’ when chewed but bread forms a sticky lump. This means you may be able to eat some solid foods but not others.
There are further tips on how to:
- ‘fortify’ your food (add things to it so it gives you more of the nutrients and energy (calories) that you need)
- manage weight loss that you did not intend
How can I choose foods which are suitable for me?
Use the tables below to help you to choose foods that you will be able to swallow.
Be aware
Try to eat as many different types of foods as you can.
| Type of food | Foods which may be more difficult to swallow. Be cautious if you try to eat these. | Normal to soft foods | Easy to swallow | Liquids |
|---|---|---|---|---|
| Meat | • Tough, gristly or chunky cuts of meat • Hard, crispy meat such as chops, steak, bacon • Sausages with skins, burgers | • Tender cuts of meat • Finely minced or chopped meats, skinless sausages • Casseroles or stew • Quorn or Soya based alternatives Try having the foods above with gravy or sauce | • Pastes and pate • Meat pureed with plenty of gravy or sauce | • Blended meat-based soups (oxtail soup, BIG soups) • Clear meat-based broth or stock cubes • Bone broth |
| Fish | • Bony fish • Crumbed and battered fish • Shellfish such as mussels, oysters, cockles and winkles • Calamari (squid), octopus | • Fish fillets • Poached, steamed and boil in the bag fish with sauce or butter • Prawns • Fish cakes or crumbed fish with sauce • Fish pie with extra sauce | • Finely flaked fish with sauce (plaice, basa fillet, sole) • Fish or seafood mousse, pate •Taramasalata • Chopped shellfish with mayonnaise (dressed crab, prawn cocktail) | • Blended fish or seafood-based soups (haddock chowder) • Fish-based broth or stock cubes |
| Eggs | • Fried eggs • Hard boiled eggs | • Hardboiled egg mashed with mayonnaise, butter or salad cream • Scrambled • Softy poached • Soft boiled • Soufflé • Lightly cooked omelette • Quiche (crustless) | ||
| Cheese | • Chunks of hard cheese • Cheese with rind such as brie and camembert • Cheese on toast | • Grated hard cheese • Quark • Soft cheese (brie without the rind, burrata, cottage cheese, ricotta) • Cheese triangles or squares | • Cream cheese • Smooth cheese spread • Cheese sauce (Bechamel) | |
| Bread and bakery products | • Fresh bread • Crusty bread • Hard pastry • Bagels, hot cross buns • Doughnut • Yorkshire pudding • Flapjack, brownies • Biscuits with nuts and dried fruit | • Well buttered toast (day-old bread or sourdough bread) • Dunk bread into soups and sauces • Croissants • Soft cakes, muffins, sponge cake, blinis, pancakes • Cookies, shortbread, biscuits • Breadsticks or cheese twist • Melba toast • Ritz and Tuc biscuits • Cheddars, cheese thins • Wafer biscuits • Meringues | • Bread crumbled into soups and sauces • Dunked biscuits | |
| Breakfast cereals | • Cereals with added fruits, nuts or both • Course cereals such as muesli, oat crunch cereal, puffed wheat, shredded wheat and all bran | • All other cereals | • Porridge, hot oat cereals (Ready Brek or Oat So Simple) • Weetabix and Oatibix Add lots of milk to soften if you need to | • Breakfast drink (Weetabix to Go or Up & go or Fuel) |
| Potatoes, rice, pasta | • Crispy chips • Roast potatoes • Potato skins | • Well cooked pasta and rice, in sauces (mac & cheese or chicken broth or curry sauce) • Mashed potato • The inside of jacket potato • Couscous • Well cooked noodles in soup or sauces • Tinned spaghetti in sauce | • Smooth, creamed potato (Instant Mash or frozen options) • Smooth sweet potato | • Potato, rice or pasta blended into soups |
| Vegetables | • Chunks of raw or stringy vegetables • Lightly streamed, boiled or microwaved vegetables | • Well cooked vegetables • Finely grated raw vegetables • Baked beans and other pulses • Mushy peas • Dahl • Houmous • Vegetable or bean-based patties, sausages | • Pureed or mashed vegetables (parsnips, swede, carrots, butternut squash) • Creamed spinach • Guacamole • Vegetable pate • Baba ghanoush • Passata or vegetable-based pasta sauce | • Vegetable juice • Creamed vegetable soup • Vegetable broth • Smooth lentil soup • Blended vegetable soups |
| Fruit | • Hard fruit such as unripe pears, melon or apple • Dried fruit • Fibrous or pithy fruit such as pineapple or citrus fruit | • Soft peeled fruit • Tinned fruit • Stewed fruit | • Mashed fruit • Pureed fruit | • Fruit juice • Fruit smoothies • Fruit coulis |
| Puddings | • Hard pastry • Puddings with dried fruits, nuts or both | • Milk or rice puddings • Jelly • Sponge puddings and moist cake • Ice cream or sorbet with added fruit or chocolate • Fruit crumble • Trifle • Cheesecake • Tiramisu • Egg Custard | • See fruit selection. Serve with custard, ice cream or double cream • Smooth yoghurt or fromage frais • Smooth milk puddings such as semolina and custard • Mousse, crème caramel, panna cotta • Creme Brulee | • Ice cream • Thin custard • Cream • Smooth sorbet • Yoghurt drinks |
Be aware
You can modify the food suggestions in the table above to fit your dietary needs and preferences. For example, choose options which are: (V) = vegetarian, (VE) = vegan, (LF) = lactose free or Halal.
How can I eat better to feel better?
This section gives you some ideas to help you increase the amount of protein and energy you are getting using drinks, snacks and ‘food boosters’
This is important if you do not have much of an appetite or you have lost weight without meaning to. Eating well is important to provide your body with the nutrients it needs to work properly.
Try our 1 and 2 approach: 1 pint of Fortified Milk and 2 Snacks
Top Tips:
- Eat ‘little and often’ throughout the day. Try to have 3 to 4 small meals with snacks in-between
- Indulge in foods that you fancy. Opt for the full fat versions.
- Have a pudding once or twice a day. For example, full fat yoghurt, ice-cream, cake or custard.
- Consider ready meals or a meal delivery service instead of cooking from scratch. For example,
- Meals on wheels West Sussex Apetito Phone: 01903 718893.
- Wiltshire Farm Foods wiltshirefarmfoods.com Phone: 0800 077 3100.
- Oakhouse Foods oakhousefoods.co.uk Phone: 0333 370 6700.
These all provide soft and pureed meal options.
Drinks
Drinking plenty is important to help you:
- feel alert
- reduce your chance of having a fall
- reduce your chance of getting a urine infection (UTI).
Aim to drink 6 to 8 cups of fluids every day. These can include water and drinks such as tea, coffee, milk, smoothies, or fruit juice.
Try soups and shakes which give you extra nutrients (nutritional supplement drinks). These include Complan, Meritene, Energis, and Aymes. You can buy them from pharmacies and supermarkets. They come in neutral, sweet and savoury flavours and as both powders which you mix with a fluid or ready-mixed.
1. Fortified milk: Have 1 pint every day
Fortified milk: add 4 tablespoons (40g) of dried milk powder into 1 pint of whole milk.
Mix the powder with a small amount of milk to make a paste and then whisk in the rest of the milk. Use this as you would do normal milk. For a single serving, add two tablespoons of dried milk powder to one glass (250mls) of whole milk.
2. Snack ideas: Include 2-3 snacks per day between meals
Who can I contact if I need further advice, support or information after I have read this information?
Please contact your Dietitians Department:
St Richard’s Hospital, Spitalfield Lane, Chichester, West Sussex, PO196SE
St Richard’s Hospital
01243 788122
Ext. 35201
Worthing Hospital, Lyndhurst Road, Worthing, West Sussex, BN11 2ND
Worthing Hospital
01903 205111
Ext. 86255
Royal Sussex County Hospital, Eastern Rd, Brighton BN2 5BE
Royal Sussex County Hospital
01273 696955
Ext. 64290
Use the space below to write down any notes or questions that you’d like to ask.
This leaflet is intended for patients receiving care in St Richard’s and Worthing.
The information in this leaflet is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.
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