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Tips for Swallowing Pills

By Janie Rosman

(Page 1 of 3)  

Swallowing pills — medicine, vitamins or supplements—is the most commonly-reported problem for people living with dysphagia, according to Jan C. Pryor, MA CCC-SLP, BRS-S, Speech-Language Pathologist at University of Washington Medical Center.

Water is a usual companion with pills, yet there are alternative options besides the clear liquid.  “It is very important to take a full glass of water with pills,” says Pryor, who is also a dysphagia consultant with the National Foundation of Swallowing Disorders. “Without sufficient water, it (pill) can get stuck in the esophagus and dissolve, causing erosion in the mucosa and pain, and more trouble swallowing.” 

Maggie Kuhn, MD, Fellow, Laryngology and Bronchoesophagology, Department of Otolaryngology-Head and Neck Surgery, UC Davis School of Medicine, says “If able, we're more confident about the complete dosage being ingested when taken with water; however, for many patients with dysphagia, this is simply not an option.”

Their different consistencies make water and pills difficult to manage together. “One is held on the tongue, and the water needs to take with pill with it,” Pryor says. Sometimes, though, the water is swallowed while the pill can stick to the tongue.

People with established dysphagia may need to be assessed by Speech and Language Therapy (SALT) to determine the extent of their difficulty and the most appropriate formulations.

Check with the pharmacy or doctor to see if the pills can be crushed. While many tablets can be crushed or opened to release their granules, “some medications should not be crushed—anything that is time released—and you might not know this,” Pryor says.

If the pill can be crushed, then either consult a compounding pharmacy — which changes the formulation (solid to liquid) and delivery, not the key contents — or crush it yourself and mix it with liquid or a soft solid, like pudding or applesauce; helpful for those with difficulty juggling a pill and a glass of water. The soft substance also helps mask the taste of a bitter medication. “When the two (pill and soft substance) stay together and move through the throat at the same velocity — the pill in the substance like a little raft — people can have an easier time,” Pryor says. “(The) caveat here is, some medications are not to be taken with milk products, so (caregivers) need to be aware of this before putting them into ice cream, for example.”


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