Dysphagia Knowledge Hub — 吞嚥困難知識庫

Travelling with Dysphagia: Practical Tips for HK and Asia Trips

TL;DR: Travelling with a dysphagia patient is genuinely more complex than travelling alone — but it is very possible, particularly within Asia where rice congee, steamed dishes, and soft soups are culinary staples. The keys are preparation before departure, the right equipment in your carry-on, and knowing which questions to ask at each stage. This guide covers the journey from HKIA departure to the hotel meal, including specific tips for mainland China travel, dim sum halls, and airline accommodations.

Before you leave: planning and documentation

Medical documentation to carry

Bring a brief medical summary (half a page of A4) in the relevant languages, stating:

• The patient’s diagnosis and dysphagia severity
• The prescribed IDDSI level for food and drinks (with the full IDDSI level name, not just a number — hospitals in some countries may use different systems)
• Current medications and any food-drug interactions
• Emergency contact information including the treating speech therapist and family doctor in HK
• Any allergy information

For travel to mainland China, have the document in simplified Chinese (普通话). For Japan, Japanese translation is highly recommended. For Southeast Asia, English is generally sufficient in hospitals and hotels, though a basic phrase card in local script helps at restaurants.

The Hospital Authority speech therapy department can provide a standardised letter on request — ask your speech therapist at the next appointment. This letter is particularly useful when negotiating with airlines and hotels.

Insurance

Standard travel insurance policies have exclusions for “pre-existing conditions”. Read the exclusions carefully. For a patient with dysphagia due to stroke or Parkinson’s disease, look for a policy that explicitly covers acute exacerbations of pre-existing conditions. Some insurers offer an “extended pre-existing conditions” rider for an additional premium. This is worth the cost — aspiration pneumonia requiring hospitalisation abroad is extremely expensive.

In HK, Blue Cross, Bupa, and AXA all offer travel policies with pre-existing condition options. Compare at MoneyHero or the Insurance Authority consumer platform.

The airport: Hong Kong International Airport

HKIA has several options that work reasonably well for different IDDSI levels.

Before security (Terminal 1 and 2, Arrivals Hall)

• Congee shops: Multiple outlets selling Cantonese congee (粥) throughout the terminal. Plain congee with simple toppings (fish, soft-boiled egg) is naturally IDDSI Level 3–4. Request “without crispy toppings” (唔要炸嘢) and check for any crouton-style additions.
• Jollibee / McDonald’s: Congee is available at McDonald’s HK outlets including in HKIA. The McD congee is consistently Level 3 in texture with minor modifications (no garnish).
• Fresh juice bars: For patients on thickened liquids, avoid these — fresh juices are thin (Level 0) and cannot be used without thickener added.

After security (Departures)

• Café Deco / Chinese restaurant outlets: Several have congee and steamed dishes available throughout the day.
• 7-Eleven and Wellcome: Carry tinned congee (e.g., Narcissus brand) and shelf-stable soft foods — useful for delays.
• Pack your own thickener: Thickener sachets (Quickeze travel packs, Resource ThickenUp individual sachets) can be carried through security as they are dry goods, not liquid. Bring more than you think you need — sachets are hard to find internationally.

At the airport lounge

If travelling business class or with an eligible credit card (Cathay Pacific Visa Signature, Priority Pass), airport lounges generally have food staff who can accommodate special texture requests with advance notice. Call the lounge’s guest services number the day before departure.

Airlines: requesting modified meals

All major airlines serving HK allow special meal requests, but the quality and accuracy of implementation varies considerably.

How to request

Make your special meal request at the time of booking or no later than 72 hours before departure. Most airlines have an online portal or allow requests by phone. For dysphagia-specific needs, the standard special meal codes are limited — there is no IDDSI-specific code. The closest options:

• BLML (Bland meal): Soft, easily digestible. Not texturally modified — often includes bread rolls and firm vegetables.
• SPML (Special meal): A free-text request that lets you specify. Write something like: “SPML — soft/pureed food required, minced textures, no whole hard foods, no crunchy toppings. Medical need: dysphagia.”

A written note from the speech therapist helps if the airline pushes back.

Airlines with better track records for special meals (HK routes)

• Cathay Pacific: Generally responsive to SPML requests; business and first class can handle texture modifications on-board if you speak to the cabin supervisor at boarding.
• ANA / JAL: Japanese airlines are particularly conscientious about special meal requests; soft rice options and soft protein dishes are standard.
• Singapore Airlines: Good compliance; mention the request again at check-in to flag it on the boarding record.
• Budget carriers (HK Express, AirAsia, Scoot): Generally do not offer special meals. For these routes, bring all food from home in an insulated bag. Security allows pureed food and soft food through in containers of any size (food is not subject to the 100 mL liquids rule in most airports — but check your specific route).

Bringing your own food on the aircraft

Sealed commercially-prepared modified texture foods (vacuum-packed purées, etc.) are allowed as carry-on in most jurisdictions. Home-prepared purées in sealed containers are also generally allowed but may attract inspection. Label them clearly. Keep a letter from the doctor in the same bag.

For thickened drinks on the aircraft: mix the thickener with water or juice from the cabin service into your own cup. Ask the flight attendant for a small cup of water before drinks service begins so you can prepare.

Hotel considerations

Booking the right room

• Request a room with a kettle and mini-fridge at minimum. A microwave is very useful for reheating prepared foods.
• Some suites and serviced apartments have a small kitchen. For trips longer than 3–4 days, a kitchen dramatically reduces dependence on restaurant food.
• Ask the hotel directly (by email before booking is confirmed) whether the kitchen can prepare puréed or soft-textured meals. Get the answer in writing. At check-in, visit the restaurant manager and clarify what was agreed — telephone staff and restaurant staff may not have communicated.

What to pack for hotel cooking

The following items, carried in checked baggage, enable significant food preparation in a standard hotel room:

• Portable mini blender: The Philips HR2546 (or similar) is small enough to pack, powerful enough for soft cooked foods, and dual-voltage. Available at Fortress HK, around HK$200. A blender cup with a travel lid also serves as a drinking vessel.
• Thickener sachets: Pack 20–30% more than your calculation. Humidity and travel can cause clumping — carry in a sealed ziplock bag.
• Instant congee sachets: Available at Park N Shop and Wellcome (e.g., Narcissus, Yummy House brands). Require only hot water from the room kettle. A base to which you can add soft proteins.
• Tinned or retort-pack soft foods: Tinned minced fish (豆鼓鯪魚, mashed before serving), tinned soft tofu, retort-pack congee. These pack flat and do not raise airline liquid concerns.
• Small colander / fine mesh strainer: Useful for straining blended foods to remove any remaining fibrous material.
• Plastic measuring cup: For consistent thickener ratios — crucial, especially in a new environment when you may be tired.
• Scissors: For cutting noodles and soft foods at restaurants. Keep in checked bag for the outward flight; transfer to carry-on for restaurant use during the trip.

Communicating with hotel staff

Prepare a brief card in the local language explaining the dietary requirements. For mainland China travel, the phrase is:

我的家人患有吞嚥困難，需要食物切碎成4毫米或以下，並且要充分濕潤，不可有整塊食物或脆硬食物。飲品需要加入增稠劑。請廚房特別照顧。

For Japan:

家族が嚥下障害を持っており、食べ物は4mm以下に細かく刻み、十分に湿らせる必要があります。硬い食べ物やパリパリした食感のものは避けてください。飲み物には増粘剤が必要です。

Having these as laminated cards reduces communication friction at every restaurant and hotel.

Restaurants: strategies that work

General principles

• Arrive early or during off-peak hours when kitchen staff have more time and bandwidth to accommodate requests
• Speak to the manager, not only the serving staff — modification requests need to reach the kitchen
• Order soup-based dishes: In Chinese, Japanese, Korean, and Southeast Asian cuisines, soup-based dishes with soft protein and soft-cooked noodles are the default, not the exception
• Inspect every dish before the patient eats — kitchen staff sometimes misunderstand and provide regular-texture food
• Carry small scissors at all times for table-side cutting

Dish types that adapt well to dysphagia

In most Asian restaurants:

• Congee / jook / okayu / zhou: Universally available, naturally Level 3–4 as served, IDDSI-compliant with simple modifications
• Steamed egg dishes (蒸蛋): Naturally Level 4
• Tofu dishes (soft or silken): Level 4–5 depending on preparation
• Fish cake and fish paste dishes: Often naturally Level 5 if moist
• Soft-cooked noodles in soup (cut into 3–4 cm pieces): Serviceable Level 5 if noodles are well-cooked
• Japanese chawanmushi (savoury steamed egg custard): Naturally Level 4, widely available in Japanese restaurants and hotel buffets throughout Asia

Dim sum hall guide

Dim sum in Hong Kong is a social institution, and it is entirely possible to attend a dim sum meal with a dysphagia patient. Planning is required.

Items that generally work:

• Har gau (蝦餃): Steamed shrimp dumpling — skin becomes very soft when freshly steamed; cut into 4–6 pieces; pass the fork pressure test on the filling
• Cheung fun (腸粉): Rice noodle rolls — the noodle itself is naturally Level 5 when cut into 3–4 cm strips; avoid those with crispy filling options
• Steamed egg tart custard (蛋撻 custard only, without pastry): The filling is naturally Level 4–5
• Mango pudding / sago pudding: Typically Level 4 and served everywhere
• Turnip cake (蘿蔔糕) if pan-fried version is avoided: Steamed turnip cake is softer; test with fork pressure before serving
• Congee (粥): Most dim sum restaurants serve congee; good base with simple toppings

Items to avoid:

• Anything deep-fried (crispy exterior will fail texture tests regardless of interior)
• Char siu bao pastry (the bread component is chewy and elastic — remove and discard, use filling only)
• Spring rolls, egg rolls, radish pastry
• Any dish labelled 脆 (crispy) or 炸 (deep-fried)
• Peanuts and sesame as garnishes

Practical tips for dim sum:

• Arrive when the restaurant opens (typically 7:30–8:30 am) — dishes are freshly steamed and at their softest
• Ask for each item to be served directly to your table rather than from the trolley — this allows you to request freshly steamed items and avoid pre-cooled, toughened dim sum
• Bring your own small scissors and, if needed, a pot of thickener for tea

Mainland China travel tips

Mainland China presents both advantages (Chinese cuisine is naturally well-suited to soft-food modification) and challenges (communication, food safety, and supply chain differences).

Congee (粥) is universally available at breakfast across every tier of hotel and restaurant. It is the single most reliable safe food option for a dysphagia patient in mainland China.

Tea: Hotel buffet breakfast tea is thin (Level 0). Always have thickener ready. Premixed thickened drink sachets (available from suppliers in HK before departure) are easier than mixing thickener from powder in a restaurant setting.

Thickener supply: Commercial thickeners (Resource ThickenUp, Quickeze equivalents) are available in China through Tmall and JD.com, but not at physical pharmacies in all cities. Bring from HK. If you run out, starch-based thickeners (澱粉增稠劑) can be found at pharmacies in larger cities, but verify the product and read instructions.

Food safety: In mainland China, hot food prepared at the table (hotpot, soup bases) is generally safer from a bacterial standpoint than pre-prepared cold dishes. For dysphagia patients, focus on hot-served, well-cooked dishes and avoid room-temperature buffet items that have been sitting out.

Hospital access: If an aspiration event occurs requiring hospitalisation, major mainland cities (Beijing, Shanghai, Guangzhou, Shenzhen) have hospitals with English-speaking departments. Outside major cities, language will be a barrier — the medical summary card in simplified Chinese is essential. The HK SAR government’s mainland office can assist in an emergency: 1868 (Emergency Assistance hotline from mainland China).

A note on quality of life

It is worth naming something that the medical literature rarely addresses: the social dimension of eating matters to dysphagia patients. Attending a dim sum lunch with the family, eating in a restaurant rather than at home — these are important for psychological wellbeing, dignity, and sense of normalcy.

Refusing all travel and all restaurant meals to eliminate risk is understandable but has its own costs. A thoughtful approach — planning carefully, accepting some level of managed risk, and prioritising the patient’s expressed preferences alongside safety — is more aligned with good care than total dietary restriction.

Travel is possible. It requires more planning than it used to. Plan the planning, and then go.

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For home IDDSI testing of food and drinks before travel, see IDDSI Testing at Home: A Complete Guide. For daily meal planning at home, see 7-Day IDDSI Meal Plan.