When there is a problem with swallowing in the voluntary (oral or pharyngeal) phases, patients will usually say that they cannot swallow properly, but they do not characteris- tically describe ‘food sticking’. Instead, when they try to ini- tiate a conscious swallow, food fails to enter the oesophagus, stays in the mouth or enters the airway, causing coughing or spluttering. Virtually all causes of this type of dysphagia are chronic neurological or muscular diseases.