The first stage in providing advice to patients suffering with dysphagia is to confirm the extent of the problem. Assessing an individual's ability to swallow can be a brief simple assessment or can involve more complex invasive procedures. Pharmacists should enquire as to the results of the assessment and the extent of the problem.

The primary aim of the assessment is to confirm whether the oral route is safe and if so, to determine the texture of food or drink that the patient will find easiest to swallow.

The initial swallow test is a simple test where the patient is asked to swallow 150ml of water as quickly as they can. The time they take to drink all of the water and the number of swallows required is recorded. Sometimes patients are also asked to eat a soft piece of fruit or pudding as well. Where this test shows signs of a swallowing problem, such as coughing on swallowing or taking more than one minute to swallow the specified volume, the patient may be given a video fluoroscope test. This involves the patient swallowing food or drink of differing consistencies mixed with nontoxic barium liquid.

An X-ray machine continuously records the test showing the barium contrast media and allowing the patient's swallowing reflex to be studied in detail.

A nasoendoscope, manometry or gastroscopy test may also be used to identify or confirm the nature of the swallowing problem.

Confirmation of the specific phase of the swallow that is affected can help with the development of management strategies to maximise safety and minimise any risk during feeding, drinking or administration of medicines.

Patients diagnosed with dysphagia should be regularly reviewed and assessed by healthcare professionals with the relevant skills and training in the management of swallowing disorders.

Healthcare professionals should consider nutritional support for any patient assessed as being able to swallow but showing signs of malnutrition or at risk of malnutrition as a consequence of swallowing difficulties.