Guest post by Leanne Goldberg, MS, CCC-SLP, Speech and Language Pathologist, The Eugen Grabscheid MD Voice Center, Department of Otolaryngology-Head and Neck Surgery.
If you experience difficulty swallowing pills as an adult and are almost embarrassed to admit it – don’t be. A recent nationwide survey conducted by Harris Interactive found that a staggering 40 percent of American adults have experienced difficulty swallowing pills, but do not experience issues ingesting food or liquids.
As a clinical swallowing specialist, a common complaint I hear from my patients, is that they have difficulty swallowing pills. Often times, this is in the absence of any other difficulty swallowing food or liquids. If you are experiencing any difficulty with swallowing liquids and or foods in addition to the difficulty with pills, you should seek guidance from a medical professional who specializes in dysphagia (difficulty swallowing).
What Causes Swallowing Difficulties with Pills?
Most of patients coming to Eugen Grabscheid MD Voice Center report trouble with larger pills and capsules, but I also hear about difficulties with smaller sized pills. This may be due to an emotional and/or physical issue. Some of the most common reasons an adult may have difficulty swallowing pills include:
- A hypersensitive gag reflex (also known as a laryngeal spasm)
- Gastroesophageal reflux disease (GERD) – the acid backing up into the esophagus may cause damage that could lead to spasms or narrowing of the esophagus
- Emotional or anxiety issues – generally stemming from a past experience
- Aversion to taste – many pills have an unpleasant coating and liquids can be equally objectionable
- Scleroderma – scar-like tissue buildup that can weaken your lower esophageal ring
- Radiation therapy – this head and neck cancer treatment can cause swallowing disorders that may occur even years afterward
Swallowing Solutions
If the cause of swallowing difficulty is unknown, a simple way to ingest pills is to place them in the center of a teaspoon full of applesauce (or yogurt or pudding) and let the pill slide down with the puree consistency.
To combat the hypersensitive gag, one could take a deep breath, hold it, place the pill in the middle of the tongue , take a sip of liquid and swallow firmly – all while maintaining a breath hold. One can also inquire if the medicine is available in liquid form and if not, cut a pill in half, or crush it and place it in a teaspoon of applesauce, and take it that way. This must be approved by your doctor, as certain medications cannot be crushed.
Check Your Head Position
A common misconception about swallowing pills is that it’s easier to tilt your head back when taking a pill. However, this is very dangerous, as it opens up the airway – the anterior tube in the neck – and gives the pill a direct shot to the airway. A neutral head position, or even better, a chin towards chest position (also known as the “lean forward position”) is largely a safer way to swallow pills.
Another tip is to simply relax when swallowing pills and wet your whistle beforehand – take a sip of a cold beverage first and then tackle the task with the solution that works best for you.