MS Swallowing Difficulties: What to Log

Updated 29 Oct 2026

Swallowing problems with MS can be quiet: a meal that takes longer, a cough with water, a mouthful that seems to stick. Because they come and go, they are easy to forget by the time you see your team.

This guide covers what to log for MS swallowing difficulties: the signs to note, which foods and drinks are hard, mealtime habits, fatigue and relapse timing, and what to bring to a speech and language therapist.

Why swallowing difficulties are worth logging with MS

Multiple Sclerosis Journey (part of Health Journey Labs) reviewed guidance from the MS Trust and the MS Society. The MS Trust explains that chewing and swallowing involve the coordination of a number of muscles in the mouth and throat, including those which protect your windpipe, and that damage to the central nervous system caused by MS can weaken those muscles or disrupt their coordination (MS Trust). It adds that this can also affect the way you sense food and drink in your mouth and throat (MS Trust).

The MS Trust says studies have found that around a third of people with MS experience swallowing difficulties to some degree, that more significant symptoms are more likely with more advanced MS, and that mild or occasional difficulties can be present early on and can also occur during relapses (MS Trust).

A dated log helps because the pattern matters: which meals, which textures, and which weeks. That is what a therapist will want to know.

In Multiple Sclerosis Journey, the Daily check-in keeps swallow notes on the same day as other symptoms.

What to log about the signs

The MS Trust lists ways MS may affect swallowing: difficulty chewing food or controlling liquids in your mouth, food getting stuck or feeling as if it is stuck in your throat, episodes of coughing or choking when eating or drinking, and difficulty controlling saliva, which may cause you to dribble.

It explains what can sit behind each one: weak muscles can make chewing effortful and tiring and mean you need to swallow several times to clear one mouthful; slow or poorly coordinated movements can let fluid or food particles enter the windpipe, causing coughing; and reduced sensation can mean saliva is not swallowed away so automatically (MS Trust).

Log each episode with the date, the meal, and what happened, such as cough with water, food sticking, or a long meal. Over a few weeks, the log shows which signs are yours.

In Multiple Sclerosis Journey, the Daily Journal records what happened in your own words.

What to log about foods and drinks

The MS Trust suggests being aware of the types of food more likely to cause problems, and notes that if dry food or thin liquids, such as plain water, are harder, you can find ways to make them easier, such as altering the size of the mouthful, the cutlery you use, or how you cook the foods.

The MS Society adds that adapting food might mean moistening dry foods with sauce or having softened foods, that some people find naturally thicker drinks such as smoothies easier, and that thickeners can be added to liquids, with a speech and language therapist suggesting the right consistency.

Log which foods and drinks were hard and which were fine, with a note on texture: dry, crumbly, thin, or mixed. That turns a vague worry into a list a therapist can work with.

For food notes, see what to track about food and MS fatigue.

In Multiple Sclerosis Journey, the Food Tracker records which foods and textures were hard.

What to log about mealtime habits

The MS Society lists simple changes a speech and language therapist may recommend: keep a good, upright posture when eating and drinking, and stay upright for at least 30 minutes after a meal; keep your head upright or tilted slightly forwards; eat in a relaxed atmosphere and avoid distractions like TV or your phone; do not rush or take too big a mouthful; chew well; drink between mouthfuls; and avoid speaking while you eat, because speaking and eating can interfere with each other and could increase the chance of choking.

The MS Trust adds that if you are prone to choking while eating, try to eat while someone is with you who knows how to help.

Pick one habit at a time and log whether you kept it and how the meal went. Over a week, you can see which change helped.

In Multiple Sclerosis Journey, Weekly Goals sets one small aim, such as staying upright after meals, and shows whether it held.

What to log about fatigue and relapse timing

The MS Trust suggests that having smaller meals more often, or having your largest meal when you are least fatigued, can help, and notes that swallowing difficulties can occur during relapses.

The MS Society lists changing meal times so you do not have to eat when you are tired among the things a speech and language therapist might suggest.

So log the time of each hard meal and your fatigue level that day. If swallowing gets harder during a relapse, mark the start and end, so you can see whether it settled with the relapse. If hard meals cluster late in the day or after a busy morning, that is useful too, because it points to moving your main meal to a time when you have more energy.

If you are unsure whether a harder week is a relapse or a tired stretch, a dated note still helps your team decide. See how to tell an MS relapse from a bad day.

For relapse weeks, see how long an MS relapse lasts and what to log.

In Multiple Sclerosis Journey, the Flare Tracker marks relapse days with intensity and duration.

What to bring to a speech and language therapist

The MS Trust says a speech and language therapist can assess how your swallowing is affected and advise on posture, consistencies of food and drinks, eating environment, and possible exercises to strengthen the muscles involved, working with physiotherapy and dietitian colleagues.

The MS Society warns that if swallowing or chewing become very difficult, you could lose weight or become dehydrated, and that food or drink going down the windpipe can lead to chest infections called aspiration pneumonia. Those are reasons to ask your MS team for a referral rather than wait.

Bring dates of coughing or choking episodes, the foods and drinks that are hard, how long meals take, any weight change, and chest infections. Add the questions you want answered.

In Multiple Sclerosis Journey, the Doctor Report turns those weeks into a summary for your team.

How Multiple Sclerosis Journey can help

A single hard meal is easy to shrug off. The harder part is keeping swallow episodes, textures, habits, and relapse weeks in one dated record, so your team can see the pattern.

Multiple Sclerosis Journey is a personal MS tracker from Health Journey Labs on the App Store and Google Play. It records symptoms, relapses, medicines, and tests in one dated history. For a side-by-side look at MS trackers, see the best multiple sclerosis apps in 2026. Below is what you can use and how each part helps:

• My Meds — Medicine names and timing, including disease-modifying therapies and symptom medicines, so you can line up timing with fatigue and function weeks.
• Daily check-in — A short guided pass across symptoms, mood, nutrition, sleep, exercise, meds, and external factors, including fatigue, mobility or sensation, and fog.
• Flare Tracker — Mark a day clearly worse than your usual hard week, with a category, intensity, and duration, so you can tell a one-off spike from a pattern.
• Daily Journal — Freer notes, including voice when fog or fatigue makes typing hard, such as heat or travel context and workplace asks.
• Weekly Goals — Set one small aim, such as a short rest before the hottest part of the day or a daily stretching routine, and see whether it held.
• My Labs — Result dates for MRI, spinal fluid, blood counts, vitamin D, or other tests, so each result sits next to how you felt that month.
• AI companions — Clara and specialist companions already see your logged history, which helps with visit wording or pacing ideas.
• Doctor Report — Two views: the Appointment Planning Report, a list of questions to prepare before a visit, and Generate Report, a dated summary of your recent progress to show a doctor saved in My Care Team.
• My Care Team — A profile for each clinician, plus visit notes used before, during, and after appointments.
• Learn — Short education topics on fatigue, heat sensitivity, pacing, relapse versus bad day, and visit preparation.
• My Assessments — Structured check-ins that add context about you across weeks.
• Period Tracker — Cycle dates and flow, so you can line up cycle timing with fatigue, fog, or heat weeks.
• Food Tracker — Meal and drink lines when food, caffeine, or alcohol comes with worse energy, sleep, or fog days.
• Weight Tracker — Weight entries when weight is part of what you and your clinician are watching.

Everything you log builds one history. Guided forms include the key questions, and you can add custom symptoms when you need your own labels. Multiple Sclerosis Journey is free to download.

Sources

• MS Trust — Swallowing
• MS Society — Managing MS swallowing difficulties

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