Two similar words, two different problems
- Dysphasia (aphasia): difficulty with language. “Phasia” relates to speech.
- Dysphagia: difficulty with swallowing. “Phagia” relates to eating.
Aphasia and dysphasia are often used interchangeably; aphasia is more common in English-speaking countries today.
What dysphasia (aphasia) is
- Difficulty finding words or names.
- Using the wrong words or sounds.
- Short, effortful sentences.
- Difficulty understanding speech, especially fast or complex.
- Problems reading and writing.
- Intelligence and memory usually preserved.
Types of aphasia
- Expressive (Broca’s): understanding is better than speaking; speech is effortful.
- Receptive (Wernicke’s): fluent speech that may not make sense; understanding is affected.
- Global: severe difficulties in all areas.
- Anomic: mainly word-finding difficulties.
- Primary progressive aphasia: gradually worsening, linked to dementia.
What dysphagia is
- Coughing or choking when eating or drinking.
- A wet or gurgly voice after swallowing.
- Food sticking in the throat or chest.
- Food or drink coming back through the nose.
- Drooling or difficulty controlling saliva.
- Weight loss and repeated chest infections.
Causes of each
- Both: stroke, head injury, brain tumours, dementia, Parkinson’s disease, multiple sclerosis, motor neurone disease.
- Mainly dysphagia: head and neck cancer and its treatment, reflux, oesophageal narrowing, ageing.
Damage to the left side of the brain commonly causes aphasia; damage to either side or the brainstem can cause dysphagia.
What about dysarthria?
Dysarthria is different again: slurred or unclear speech caused by weakness or poor coordination of the speech muscles. Language is intact. It often appears with dysphagia because the same muscles are involved.
After a stroke
Aphasia and dysphagia are common after stroke. Swallowing is screened before a person eats or drinks, to prevent aspiration pneumonia. Early speech and language therapy supports recovery of both communication and swallowing.
Assessment
- Aphasia: language tests of naming, understanding, repetition, reading and writing.
- Dysphagia: bedside swallowing assessment, videofluoroscopy (X-ray of swallowing) or fibreoptic endoscopic evaluation of swallowing (FEES).
Treatment for aphasia
- Word-finding and naming practice.
- Sentence and conversation work.
- Communication strategies: gestures, drawing, writing key words.
- Communication aids and apps.
- Training family in supported conversation.
Intensive therapy and practice over time improve outcomes for many people.
Treatment for dysphagia
- Swallowing exercises to strengthen muscles.
- Safe swallowing strategies, such as chin tuck and small sips.
- Texture-modified foods and thickened drinks.
- Good mouth care to reduce chest infections.
- Tube feeding in severe cases, sometimes temporarily.
Tips for communicating with someone with aphasia
- Reduce background noise.
- Speak clearly, in short sentences, without talking down.
- Give time to respond.
- Use yes/no questions and gestures.
- Check understanding.
See speech delay treatment for language difficulties in children.
Pronunciation and spelling
Dysphasia is pronounced dis-FAY-zha and dysphagia dis-FAY-ja. The difference of one letter changes the meaning completely, which is why health professionals often prefer the word aphasia for language problems to avoid confusion in medical notes.
Living with aphasia
Aphasia can affect work, friendships and confidence. Support groups, communication-friendly information and patience from others help people stay connected. Carrying a card that explains the condition can make everyday situations such as shopping or phone calls easier.
Eating safely with dysphagia
Sitting upright, eating slowly, taking small mouthfuls, avoiding talking while eating and staying upright for 30 minutes after meals reduce the risk of choking and aspiration. Follow the textures and drink thickness recommended by your speech and language therapist, as these are tailored to your swallow.
In children
Children can have developmental language disorder, which is different from acquired aphasia, and feeding and swallowing difficulties linked to prematurity or neurological conditions. Both are assessed by paediatric speech and language therapists.
When to seek urgent help
- Sudden difficulty speaking or understanding.
- Sudden difficulty swallowing, facial droop or arm weakness: call emergency services.
- Choking episodes or breathing difficulty.
- Repeated chest infections or weight loss.
Key points to remember
- Dysphasia (aphasia) affects language; dysphagia affects swallowing.
- Both are common after stroke.
- Speech and language therapists assess and treat both.
- Sudden onset of either can be a sign of stroke.
Questions about dysphasia and dysphagia
These answers are general information and do not replace an examination or individual medical advice.
What is the difference between dysphasia and dysphagia?
Dysphasia affects language; dysphagia affects swallowing.
Is dysphasia the same as aphasia?
Yes, the terms are used interchangeably.
Can you have dysphasia and dysphagia together?
Yes, especially after a stroke.
Who treats dysphasia and dysphagia?
Speech and language therapists.
Does aphasia affect intelligence?
No, intelligence is usually preserved.
Can dysphagia cause pneumonia?
Yes, if food or drink enters the lungs.
Can aphasia improve?
Yes, many people improve with therapy, especially in the first months.
What is dysarthria?
Slurred speech from weak or uncoordinated speech muscles.
How is dysphagia tested?
With bedside assessment, videofluoroscopy or endoscopic evaluation.
Is dysphagia a symptom of a stroke?
It can be; sudden swallowing difficulty with other stroke signs needs emergency help.
Can dysphagia be cured?
It often improves, depending on the cause, with therapy and treatment.
Sources
This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.