UNC Healthy Heels

It’s cold and flu season again…and sinus infection, bronchitis, pneumonia season, etc….and what does all this mean?

Pills. Tablets. Capsules. Caplets. Gel caps.

Oh my.

In 1 study of adults in the U.S., 40% reported difficulty swallowing pills while having no trouble swallowing food or liquids. Common complaints among the non-pill-swallowers included a feeling of having the pill lodged in their throat, fear of gagging, or a bad taste in their mouth.

While some people have a legitimate inability to swallow (that is not unique to pills) termed dysphagia, in the majority of the population, fear is the biggest factor, and particularly the fear of gagging.

However, here may be some new tools to add to your pill-taking toolbox. A recent study in the Annals of Family Medicine including both people who do and do not have difficulty swallowing pills has found two options to help get the medicine down. Next time you have to swallow large, dense tablets (think about some of those giant vitamin tablets, or antibiotics!), try using the “Pop Bottle Method“.

• With this method, use a squeezable plastic bottle full of water.
• Place the tablet on your tongue,
• Make a tight seal with your lips on the water bottle
• Suck in water as you tilt your head back.

The force of the water should carry the tablet with it right on down the throat.

What if the issue isn’t a large tablet but is a capsule that just won’t go down the hatch?

Try the “Lean Forward Technique“, a trick appreciated by almost 90% of the participants in the pill-swallowing study. The idea underlying this technique is that the pill should be lighter than the liquid swallowed with it.

How to do the Lean Forward technique?

• Place the capsule on the tongue,
• Take a sip of liquid,
• Lean the head forward while swallowing.

Other options are to take only 1 tablet or capsule at a time and try taking the pill with a cold (not hot!) beverage. Warm beverages make pills dissolve more quickly, whereas cold beverages often will help the tablet or capsule remain intact for the time it will take you to swallow it. (This also cuts down on the unpleasant taste of a half-dissolved tablet!).

Still having trouble? Check out this NPR Shots post complete with videos of both the Pop Bottle and Lean Forward techniques and this WSJ post about getting over the “fear factor” of swallowing pills.

Finally, don’t hesitate to let your health care provider know that you have difficulty swallowing pills. Ask if liquid or chewable formulas may be available and could be prescribed instead. Also, remember that some medications should not be crushed or chewed; some are made specifically to dissolve very slowly in the stomach/gastrointestinal tract and crushing/chewing may make them less effective or even dangerous. To be safe, check with your pharmacist or prescriber before you crush or chew any medicine.

So, here’s hoping that you remain healthy all season long. However, if you find yourself with a prescription for tablets or capsules, hopefully these tips and tricks can help!

Here’s to your health, and here’s to getting the medicine down!