Mother Knows Best

Apparently, it has reached epidemic proportions. I see it almost every day in my work, and now it is affecting my own family. My two sons, ages 18 and 21 are suffering the effects as well.

However, just like some of the patients I treat, they brought it on themselves.

I am talking about something that sounds so benign, but yet has so many possible negative side effects: eating too fast.

I am a medically-based speech language pathologist, a.k.a. speech therapist. My day job consists of treating adults with speech, language and swallowing deficits, usually due to a stroke or some other diagnosis, but sometimes the swallowing problems have no apparent diagnosis, no reason they should exist. Except that since I have been in business for over 20 years, I have it figured out: often, the swallow problem is caused by eating and swallowing too fast.

Choking is the most obvious risk, but other risks include poor digestion, stomach pains and pneumonia. The social aspect of frequent coughing and choking cannot be denied.

On my off-hours, I love to write. I love to share information that may make your life easier; your health better, which is why you hear from me every month. I try to keep it simple, relevant, readable and applicable to your life.

Chances are, if you are among the 95% of people in the general population–I have deduced –that eat too fast, then you likely have, or will have this problem down the road.

Let me save you a lot of future heartache, stomachache, coughing/choking, complaints of swallow problems to your doctor followed by possibly unnecessary evaluations, and perhaps weight gain or loss, and let me share some professional advice with you that I am offering for free.

Here is your free medical advice, with no strings attached, no risk of causing harm to anyone: slow down and take smaller bites and sips while you eat.

I wish I could distill this into a pill, offering it as a cure for so many swallow problems I encounter in my work. I wish it were as easy as popping a capsule, and voila! Problem solved! I wish it didn’t take any lifestyle changes on your part, because as a fellow human, I know how hard it is to change bad habits and replace them with good ones. Most of us are conditioned to believe that we need a pill to solve our problems. Maybe not so with this one.

First, let me make it abundantly clear: If you have a swallow problem that is preventing you from swallowing safely as evidenced by coughing, choking and/or difficulty getting food and/or liquids to go down, you need to consult your doctor. Your first strategy—after this move—should be to take a look at your swallow habits.

Do you eat too fast? Take large bites? Are you the first one done at most meals? Do people tell you that you eat too fast—even if you don’t want to hear it? These are all red flags and should be considered in light of your swallow difficulties.

I am in no way trying to take away from the legitimacy and seriousness of swallow problems caused by stroke, head injury, Alzheimer’s disease, Parkinsons’s disease and myriad other diagnoses that do cause medical swallow problems. There are many such diagnoses that cause swallow problems, and I have likely treated them in my 24 years of practice. They are very real and need to be medically addressed. Please, if you feel you are suffering swallow problems due to any of these issues, or perhaps another medical issue you are experiencing, see your doctor. He or she will refer you to a speech-language pathologist if necessary. Difficulty swallowing may indicate a deeper problem, and it should be medically addressed.

I encounter this habit in a considerable number of swallow patients that are referred to me. In the absence of any other cause, many times it can be attributed to the patient’s habit of eating too fast, and/or taking large bites. If they don’t first volunteer it, I often ask them this pointed question: “Do you think you eat too fast?” And in the majority of cases, their answer, sometimes delivered rather sheepishly, with the head down in a quiet voice, is “yes.” Most people are willing to admit it to me when they likely won’t acknowledge it with a family member who points it out.

So, I am asking you to simply think about it. Like so many other habits we possess, we don’t know we possess them. We are not aware of our patterns of behavior, even though they may be glaringly obvious to others. Just think about it.

**

My two sons, my husband and I recently took a 3,100 mile road trip. It was mostly joy, but travel involves a lot of togetherness, and perhaps too much closeness. Inside a car together, many personal issues become family issues.

Such was the case with one of my sons. Being in a small, enclosed space like a car made it quite obvious that someone had an issue with gas. He explained that he typically has it most of the time, and has simply become used to it. His friends likely had, too. The three of us in the car with him, however, didn’t want to get used to it.

We discussed possible causes, covering potential causes such as food intolerance/allergies. He was not aware of any, nor was I as his mother.

At our next stop, we had a pizza lunch. It became apparent to me that he was eating too fast. I guess as his mother, I had become used to his rate of eating as well. I normally only worry about this when it causes choking. However, I knew of another young man with the same problem. A friend of mine was one of his teachers, and she complained of this to me. She gently explained to him this possibility. He observed himself objectively while eating, changed his patterns to slow down, and resolved the issue.

Long story short, my son did the same, and has had less of a problem. We were all thankful for the remainder of the trip, and since then as well.

My other son followed suit with his older brother, and was a champ in changing the same habit. After another pizza lunch—he ate nice and slow–he made this comment to me: “You mean my stomach can always feel this good after eating pizza?” As 6’4” 200-pound eighteen-year-old boy, he has seen his share of pizza meals.

This may seem too simple, too easy a fix for what appears to be a big problem. With a few small changes in your eating habits, however, you may be saved any more current swallow and digestive problems, and from more of the same problems later in your life.

As we age, most body functions slow down, including the swallow process for some people. If you spent your life eating quickly with no problem, it may just catch up with you later with age. I am just over 50 years old, and I can see this already. Coupled with the habit of eating quickly, this combination of advancing age and quick eating can cause problems.

Most people who maintained a busy work schedule did not have a long period of time for lunch. A prime example is teachers. I think they have, on the average, about 17 minutes to eat their lunch. Many years of eating lunch quickly is not easily undone after a teacher retires. Many other professions are the same way. Again, the first step is to take a step back and just look at your habits.

How does one go about changing this habit? Just slow down sounds too easy, but that is the goal. To accomplish this goal, I am offering the following strategies that I offer many patients—again, free of charge. They are all good bits of advice for anyone to follow, no matter what age or what swallow complaints you have.

  • Take bites that are about half the size your normal bite.
  • Put your spoon or fork down between bites. If it is finger food or a sandwich, do the same. Chew thoroughly and slowly. Swallow, and swallow again if you feel the need. Only when that bite has fully cleared you mouth should you pick up your fork and take another bite.
  • This extended period of chewing produces more saliva. Saliva, which has a bad rap for being “gross,” is actually a wonder fluid. It is filled with digestive enzymes that aid digestion. It is the lubricant that helps food pass through the mouth, throat and esophagus. Without it, we’re stuck—literally. So the more saliva, the merrier.
  • Sit down for this one: place a small table mirror in front of yourself while you are eating, preferably alone or with those closest to us. Seeing ourselves eat as others see us eat can be incredibly eye-opening, and hard to swallow—pun intended. I recommend this to many patients, but I have yet to try it myself. It can be a rude awakening.
  • Take a 5-10 minute break before taking another helping. This short respite may just be enough time for your stomach to catch up to your willpower, convincing you that you really don’t need to eat any more.
  • Minimize distractions during eating. Try not to watch television and focus on how you are eating, at least for the period of time necessary for you to fully become aware of your eating patterns.
  • Speaking of TV, be aware of where your TV is placed if you do watch it while eating. Many televisions in this age are affixed onto the wall above eye level. This requires that you tilt your head back while eating and swallowing, which can invite swallow problems. Keeping your head straight or a bit tucked down is the safest way to swallow.
  • If you struggle swallowing pills, make sure you are taking them one-at-a-time. Consider taking them with a thicker liquid like tomato juice, as the increased weight of the liquid helps carry the pill down. Some people have good luck taking their pills with applesauce or pudding.

**

Again, please contact your health care provider with any swallow problems you have. The first medicine you should take for this problem, however, is to make sure you aren’t eating too fast—just like your mother told you not to. She always knows best.

And if your mother happens to be a speech-language pathologist who treats swallow problems, then you’d better really listen—just ask my children.