EAT - 10

How to complete this Questionnaire:

  • This questionnaire helps to measure swallowing difficulties.
  • These are statements many people have used to describe difficulty swallowing / eating
  • To what extent do you experience the following problems?
  • Select the most appropriate response for each statement.
0 - 4 Rating Scale
0 = No problem
1 = Mild Problem
2 = Mild to moderate
3 = Moderate problem
4 = Severe problem
My swallowing problem has caused me to lose weight.

My swallowing problems interferes with my ability to go out for meals.

Swallowing liquids takes extra effort

Swallowing solids takes extra effort

Swallowing pills takes extra effort.

Swallowing is painful

The pleasure of eating is affected by my swallowing.

When I swallow food sticks in my throat.

I cough when I eat.

Swallowing is stressful

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