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WARNING: THIS IS NOT MEDICAL ADVICE. SEE YOUR DOCTOR BEFORE EFFECTING ANY CHANGES TO MEDICATIONS, DIET, EXERCISE OR LIFESTYLE THAT MAY AFFECT YOUR CONDITION. Hi Norm and Ruth, Here is a description of what can happen, from a non-medical person, who is however a fellow sufferer (diagnosed 13 years), and a member of a PD research team investigating the epidemiology and aetiology of Parkinson's Disease. Parkinson's Disease can affect the central nervous system. One can have symptoms affecting the muscles in any part of the digestive system. Areas that can be affected include the epiglottis (flap over the larynx (windpipe)), and the oesophagus (gullet, food pipe). Both of these can lead to a choking sensation. When the epiglottis is affected, it can "freeze", and stay open or shut. I f it freezes open, food can enter the airway, and produce a coughing fit. Food can be aspirated (breathed) into the lungs,leading to pneumonia in severe cases. If it stays shut, air will not enter the larynx, and the affected person will gasp for air. The mechanism by which food moves through the alimentary canal is called peristalsis. This a series of wave-like motions that, in the oesophagus, move a bolus (round ball of food produced in the mouth, and containing saliva) from the throat to the stomach. This motion explains why one can swallow whilst upside down. If the peristalsis is weak and/or the bolus is soft, the bolus may remain stationary. A sticky, thick mucus will form around and above the bolus. The affected person will feel a 'lump in the throat'. Usually, the only way to clear the blockage is to regurgitate the bolus. In both of the above cases, swallowing water is NOT a good idea. With the epiglottis stuck in the open position, water can enter the larynx, causing further choking and coughing. With poor peristalsis, water will sit on top of the bolus, and will back up to the epiglottis, and may find its way into the larynx. Once the blockages have been cleared, the affected person should desist from further eating for a little while, to give the system a chance to recover. The affected person may have oesophagitis (heartburn), an inflammation of the oesophagus caused by a number of things including viral or bacterial infection, over-acidity.etc. This can cause the oesophagus to work ineffectively. A gastric ulcer, whether attributable to PD or not, can also cause a partial shut-down of the system. Foods that can produce a bolus that may stick in the oesophagus include soft white bread, soft boiled white rice, some pastas, chicken breast, pastry, cake, etc. If you can form a ball of a particular food in your hand, then it could cause a problem (remembering that the bolus is chewed-up food, mixed with saliva). Remedies for the problem include: 1. Smaller meals, eaten more often. 2. Cutting food into smaller pieces, and eating smaller mouthfuls. 3. Waiting until one mouthful has been completely swallowed, before taking another. 4. Thorough chewing, particularly of meats. 5. Eating only while upright - no TV snacks while sitting on the lounge! 6. No talking during eating, unless the mouth is empty, and the last mouthful completely swallowed. 7. Cutting back on hot, or spicy, or fatty foods. 8. Avoidance of gassy, fizzy, or alcoholic drinks while eating. 9. Pharmaceutical drugs. 10. Natural medications A doctor who is fully aware of the connections between PD and digestive disorders may prescribe one or more of a number of drugs, including antacids, preparations that lower stomach acidity, and preparations that facilitate emptying of the oesophagus and/or stomach. Natural medications include yoghurt containing acidophilus bifidus, the 'friendly' bacteria that inhabit our digestive system, and herbal bitters, usual taken in water. I hope this is of assistance to you. Jim 59/13 [log in to unmask]