Difficulty swallowing tablets and capsules can be a problem for many individuals and can lead to a variety of adverse events and patient noncompliance with treatment regimens. It is estimated that over 16 million people in the United States have some difficulty swallowing, also known as dysphagia.
For these individuals, swallowing a tablet or a capsule can be particularly challenging. A survey of adults on difficulties swallowing tablets and capsules suggests that this problem goes well beyond the patient population with clinically recognized dysphagia and may affect as many as 40 percent of Americans. Of those who experience difficulty swallowing medication, less than a quarter discuss the problem with a health care professional, 8 percent admit to skipping a dose of prescribed medication, and 4 percent have discontinued therapy because the tablets and/or capsules were difficult to swallow.
Individuals who find it difficult to swallow tablets and capsules frequently blame the size. Size and shape of tablets and capsules affect the transit of the product through the pharynx and esophagus and may directly affect a patient’s ability to swallow a particular drug product. Larger tablets and capsules have been shown to prolong esophageal transit time. This can lead to disintegration of the product in the esophagus and/or cause injury to the esophagus, resulting in pain and localized esophagitis and the potential for serious sequelae including ulceration.
Two Techniques for Swallowing Pills
Researchers have found that these two pill-swallowing techniques help most people:
The lean-forward method
- Place the pill on the tongue
- Take a sip of water but do not swallow it
- Lean the head slightly forward, bringing the chin slightly down toward the chest (do not touch the chin to the chest, as this will narrow the throat opening)
- In this position, swallow the pill
The pop-bottle method
- Fill a flexible plastic water or soda bottle with water
- Place the pill on the tongue
- Wrap lips tightly around the bottle opening (so no air escapes)
- Keep lips pursed, tilt head back, and drink from the bottle with a sucking motion, swallowing pill right away
No air is allowed in or out of the bottle during this process, so drinking water will cause the bottle to collapse in on itself a bit. Experts recommend patients consult a physician or speech therapist before trying this method because leaning the head back may increase the risk for breathing in water directly into the lungs.
These techniques are successful for most but not all people who have trouble swallowing pills. A doctor or therapist may be able to recommend different pill-swallowing techniques that work better for certain individual patients.
How to swallow pills easier?
Here are a few things you can do to make swallowing medicine a little easier:
Put a pill in applesauce or pudding. The texture can make it easier to swallow pills whole.
- Grind a pill into a powder and add it to applesauce or pudding.
- Cut a pill with a pill splitter and swallow the smaller pieces one by one.
Make sure you ask your pharmacist if it’s okay to cut or grind a medication. Timed-release or enteric-coated medicines shouldn’t be broken apart. It may also be possible to get your medicine in another form such as a powder, cream, or liquid, so don’t hesitate to ask.
If you have trouble swallowing pills or anything else, don’t put off getting an evaluation. Start with your primary care physician, who will likely refer you to an ear, nose, and throat specialist or to a speech-language pathologist for a swallowing assessment. Facing the possibility that you have a swallowing disorder may be a hard pill to swallow, but learning ways to overcome it will make your future of taking medication a lot safer.
