Two tricks to make it easier to swallow pills

Heidi Godman
Heidi Godman, Executive Editor, Harvard Health Letter

The expression that something is “a hard pill to swallow” isn’t just a metaphor. Swallowing pills can be difficult and downright unpleasant. It causes one in three people to gag, vomit, or choke. That may keep people from sticking to their medication routines, which can make them sicker.

“We often see people who can swallow food and liquid just fine, but have difficulty with pills. Some people have an aversion to swallowing pills, and others have physical issues that affect their ability to swallow,” says Denise Ambrosi, director of the Speech-Language Pathology Department at Harvard-affiliated Spaulding Rehabilitation Hospital.

Hope for the pill-challenged

A study by researchers from the University of Heidelberg in Germany may help people with pill swallowing difficulties. They suggest two techniques that can help people improve their ability to get medicine down. Their report was published in the Annals of Family Medicine.

Pop-bottle-method-to-swallow-pills

Pop-bottle method to swallow pills

Image Credit: Annals of Family Medicine

The pop-bottle method is designed for swallowing tablets:

  • Fill a plastic water or soda bottle with water.
  • Put the tablet on your tongue and close your lips tightly around the bottle opening.
  • Take a drink, keeping contact between the bottle and your lips and using a sucking motion to swallow the water and pill. Don’t let air get into the bottle.

Researchers asked about 140 people with difficulty swallowing pills to test this method with their eyes closed, swallowing large and very large pills. The result: a 60% improvement in swallowing over the old method of just taking a sip of water from a cup and trying to swallow.

Study participants had even more success with a technique for swallowing capsules called the lean-forward method:

Lean-forward-method-to-swallow-pills

lean-forward method to swallow pills

Image Credit: Annals of Family Medicine
  • Put a capsule on your tongue.
  • Take a sip of water but don’t swallow.
  • Tilt your chin toward your chest.
  • Swallow the capsule and water while your head is bent.

This technique showed an improvement of 89% over the old method of taking a sip of water from a cup and trying to swallow.

You can download a handout demonstrating these techniques from the Annals of Family Medicine.

Don’t try this at home

But don’t rush to try out these pill-swallowing techniques, warns Ambrosi. “The study mainly found that people’s perceptions of pill swallowing changed,” she says. It’s true; researchers only asked participants if their pills went down easier, they didn’t get any images of what was happening physiologically during the swallowing tests, or measure physical differences.

So it’s not a given that one of these methods will work for you or be safe for you, especially if you have a hard time swallowing pills. “You’ll need a thorough assessment first. Maybe there’s something causing the swallowing problems that would only be identified with an instrumental swallowing assessment,” says Ambrosi.

Difficulty swallowing is called dysphagia. It can be caused by problems with nerves or muscles. Quite a few of those are involved in the swallowing process — 25 pairs of muscles in the mouth and throat help prepare your food for swallowing. When you swallow, your airway closes and you stop breathing for a moment. Trouble with the coordination of any of the nerves and muscles involved in the process can lead to choking or getting food or liquid into your lungs, potentially causing a type of pneumonia.

What you can do to help swallow pills more easily

Until you know what’s behind your swallowing issues, 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.

Related Information: Harvard Health Letter

Comments:

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    Swallow pills is very disgusting for. I don`t like to take this pills.But after knowing these two tricks about swallow pills it has become very easy for me.
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  2. Daniel

    I find swallowing circle shaped pills, a tad difficult.
    But rolled shaped I have no problem just can not work out why.

  3. stenny fandy

    really nice information! i have always have a problem when taking those pills. now i will keep sure to try this tips. thank you so much!

  4. Avinash Dhameliya

    Nice information, good stuff with good ideas and concepts, lots of great information and inspiration, both of which we all need; ,……!

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  6. Ruth

    I didn’t know there are others too who can’t swallow pills !! it’s nightmare for me , very annoying . I surely try these technique hope it helps thanks

  7. JJ

    Thanks for this article and the comments. I have difficulty swallowing x 2… scleroderma and a site from a tracheostomy. I found Greek (thicker) yoghurt helps and it’s easy to keep fresh in the fridge. Also, I found small high-quality caplets of vitamins (Rainbow Light Mini Tablets, calcium/magnesium (New Chapter Bone Strength), and soft gel ibuprofen (Walgreens and other stores). Best regards to all.

  8. Anna

    My mother and I had this problem with overlarge vitamin pills. A very simple solution (overlooked for years by us) was to buy the chewable vitamins that are berry flavored with the consistency of gummy bears.

  9. Bonnie Kaplan

    Although I appreciate the thoughtful article, I do think that the method we are using up here in Canada has a close to 100% success rate, and people love it. And we have posted a training video — perhaps people who do not succeed with the pop bottle system might like to take a look:
    research4kids.ucalgary.ca/pillswallowing

  10. Agus

    Thanks 😀

  11. Jodi

    I’m an SLP and I have terrible difficulty with pills of any size. So bad that I am in the percentage of those that gag the pills back into the oral cavity and often vomit . I also gag when brushing my teeth so my gag is hypersensitive . However, I have found the Valsalva in conjunction with the Masako techniques help aide swallowing pills for me but I would say at about 75% . So will definitely try your bento ones techniques about the water bottle as I have tried the second me to ones technique but has not worked for me

  12. SLP

    I’m a SLP and I have difficulty swallowing pills. I always thought it was a psychological thing but I had to have my esophagus stretched last year because I all of a sudden couldn’t swallow one night.

  13. Shelley

    I have MS and have trouble swallowing pills . I found your article very informative . Thanks for the tips.

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    It’s hard to imagine that somebody may have problems with swallowing medicines, but this article may be useful and helpful for people who had not such an experience before)

  15. Joshua Vogel

    Just a tip for other who might read this. I find that swallowing just one pill will always get stuck. But I was very surprised to learn that swallowing 2-3 pills at a time is MUCH easier!! I know, it doesn’t make sense, but it works, try it out.

  16. Isobel staude

    This is amazing! I have always battled to swallow pills. Both these ways of swallowing have helped me tremendously. Thank-you!

  17. Amanda

    My trick is to take a mouthful of food and chew it really well. Then put the pill in and swallow it all together. I never have a problem. If it’s something really delicious this method can encourage a child like nothing else.

  18. Theresa

    These harvard newsletters are invaluable and a great source of knowledge. I was especially pleased to learn about difficulty in swallowing. I have a paralysed larynx and an atrophied vocal cord so even eating normal food is a difficulty. Once again many thanks indeed.

  19. Michelle

    With my dad with LBd that monster form of Parkinson’s I have to take a bottle cap place the pills in so he can take them. He has to be told to tilt his head so the swallow happens. When he was in the rehab I call dying centers they presumed he had a swallowing silent aspiration. I knew it was different. He has had a narrow opening in throat like I do from sinus conditions. He has had clear chest x’rays. I always appreciate learning everything I can to aide my dad and myself live a better life. Sincerely Michelle who was just a associates of science in medical administration studies who feels more like a Nurse than daughter.