Do you have difficulty swallowing pills? Or does it feel like pills get stuck in your throat? Well my friend, you are not alone. According to a 2003 survey by Harris Interactive, 40% of US adults have difficulty swallowing pills and medication. Forty percent![1]Holding a pill.Credit: Jessica Hamilton

Until recently, I was one of those 40%. Often times, I got the pills down my throat okay, but then could taste them breaking down when they felt like they got stuck on the way down. Yuck, right? No one wants to taste pill innards.

Some people even have such a hard time swallowing pills they delay medication or stop taking it altogether. As a long time member of the pill swallowing challenged group, I am here to tell you my strategies to make pills go down easy. First let’s talk a bit about why you are having the trouble in the first place, because knowing why is important.



Where does Pill Swallowing Trouble Come From?
Nerves and anxiety cause a large portion of pill swallowing difficulty. Maybe you had a bad pill in the past and your throat remembers those bad times. Your neck tenses and your throat can constrict a bit when you get anxious about swallowing, which then causes a vicious cycle of failure to swallow. So, mental blocks may be to blame. But it is not always all in your head.

EsophagusCredit: Jessica HamiltonYour throat connects to a tube called an esophagus. The pill must travel down your esophagus to reach your stomach. Some people have naturally smaller openings at the base of their esophagus. For additional information on swallowing trouble, see the Swallowing Disorder section below.[2]

X-rays have shown that a dry esophagus or smaller esophageal tube can encourage pills to get stuck to the lining on the way down. This grappling situation is why you might taste a tablet or vitamin breaking down even though you swallowed it. Bad taste aside; it can be quite unhealthy for medication to cling to the esophagus as some will cause burning or irritation as it breaks down on the tissue wall. But no need to panic, my four easy pill swallowing strategies should help your pills go down—all the way down.


Four Pill Swallowing Strategies
In four simple steps, you can take most all the challenge out of swallowing your pills. Having a plan will also help relieve any anxiety you may be experiencing when facing your prescriptions. Here is what I do.

1. Waterslide. Did you ever go down a dry waterslide as a kid? Ouch. You just kinda get stuck and you’re forced to painfully scoot your way down, flipping and flopping like an awkward fish. Well a dry throat can cause a bumpy ride for your pills. Before you take the pill, drink a few sips of water to prevent dry spots for the pill to cling to. It also helps to make your mouth water a bit prior to taking the medication. My mouth waters every time I think of sour candy or JollyRanchers. Pavlov’s dog liked dinner bells. We all have mouth watering triggers—use them to your tablet-taking advantage!

Tilt Your Head ForwardCredit: Jessica Hamilton2. Say a Little Prayer (Bow Your Head). A popular misconception is that tilting your head back helps the pill go down. I blame cartoons and sitcoms where people tilt their heads back saying something like “down the hatch!” as they ingest something. It just doesn't work that way.

Tilting your head back actually makes it MORE difficult to swallow pills as the path from throat to esophagus is more constricted when your head is thrown back. Instead, tilt your head forward, like you are praying; praying that the pill will go down like it is supposed to. This position opens up the pathways for easy pill travel.


Pill OrientationCredit: Jessica Hamilton3. Make a carriage. There is no way to make this step sound normal, so I am just going to say it. You need to make a carriage, a food carriage. Basically, you take a bite of food—something like a piece of bread, cracker, marshmallow, banana—something soft and dense.

Chew up the food until it forms a nice little wad on top of your tongue. Push the pill into the center of the food. Make sure the length of the pill is parallel to your throat and then swallow (remember your head should be tilted down as you swallow). The tablet will ride down in the little food carriage, which should help prevent the pill from sticking to your throat or esophagus as it travels.



4. Follow up. Take additional drinks of water and/or food to further push that puppy down. Repeat as many times as needed until all the necessary medication is gone. Using a straw or water bottle can help you drink more liquid in a shorter amount of time as it encourages a steady stream.

That’s it! Those are the four simple steps I take to swallow a tablet or vitamin. No matter if the pill is small or large, these methods work! Just remember waterslide, prayer, food carriage and follow up. Now you’ll be a pill swallowing ninja!

Here are a few more tips:

  • Prior to taking the pills, practice taking deep breaths to calm your throat muscles.
  • Imagine the pills are nothing more than food. Most of us can swallow food with no problems. 
  • Practice swallowing small candies like you would swallow a pill.
  • Make sure you position the pill on the back center of your tongue, with the pill length parallel to your throat.
  • Only take pills when you are in an upright position. Laying down while ingesting pills or liquids can cause choking.
  • If a gag reflex is keeping you from taking your pills, try numbing the area with some ice or a popsicle prior to taking the medication.


Additional Pill Swallowing Methods
The above methods will work for most people, but may not work for everyone. Sometimes you need a little outside assistance and specialized products may help you. The Oralflo Cup and Swallow Aid are two highly reviewed products you can try to improve your pill swallowing experience.

The Oralflo Pill Swallowing Cup, made by Oralflo Technologies, has a special spout designed to hold and release the pill while you are drinking liquids so that the steady flow of liquid is uninterrupted. The angle of the spout enables you to keep your head tilted forward while taking a drink. The cup is designed for use by all ages and works with any tablet large or small. Most reviewers praise the function of the cup. One gal even said the cup improved the way she drinks liquids and that she no longer needs the cup when taking medication.

The second specialized swallowing product is called Swallow Aid. This gel comes in a tube and is cherry flavored. The flavor helps mask the taste of the pills and the gel coats the tablet making it glide easily down the throat. This gel, which is sugar free, is a great solution for medications that should be taken on an empty stomach. Swallow Aid can also help pill swallowers with gag reflex issues.

Oralflo Pill Swallowing Cup
Amazon Price: $9.95 Buy Now
(price as of Aug 21, 2015)
Swallow Aid
Amazon Price: $12.99 $10.99 Buy Now
(price as of Aug 21, 2015)

 Important Things to Consider

Less than one in four people who have trouble swallowing pills will actually mention the trouble to their doctor or pharmacist.[1] If you continually struggle to swallow your medication, talk to your health care and prescription providers. Perhaps the pill you’re taking can be halved, crushed, reduced in number or size. Some pills have more outer coating than others, which can make them easier to swallow. It never hurts to ask.

I do not recommend chewing, halving or crushing pills before you talk with your doctor. Some doses are designed with a special time-release dispensing system that can be ineffective or dangerous if the pill is broken. But some pills, such as some large antibiotics, are designed to be halved using a pill cutter, so do find out about your options.

Also, talk with your doctor or pharmacist about taking the pill with food. Some food and drink will interfere with the effectiveness of the medication, such as dairy products making antibiotics less effective, or fruit juices interfering with some allergy medications. And some pills are designed to be taken on an empty stomach. If an empty stomach is required, you may want to try one of the tools I recommend above, such as the Swallowing cup or Swallowing Aid Gel.

Gel CapsulesCredit: Jessica HamiltonCoated pills and gel capsules are generally easier to swallow. For example, generic ibuprofen tablets have a history of sticking to my throat on the way down, however the name brand Advil tablets have a smoother shape and thicker coating, which generally helps them glide down better. Now I just choose the gel capsules when taking ibuprofen, but sometimes your pill purchase options are limited.


Swallowing Disorder
If you consistently have a hard time swallowing everything—not just medications, but foods and liquids as well, you may have dysphagia. Dysphagia is a condition where foods, medications and liquids take longer to pass through your esophagus, or in the case of severe blockage, they don’t pass through at all. Dysphagia is often, but not always caused by a blocked or poorly functioning esophagus. Sometimes there are esophageal complications that can arise from other health problems, like stroke, brain injury, nervous system or immune system problems—all of these can cause the muscles in your esophagus to spasm or work improperly, which can make for difficulty swallowing.[4]

Dysphagia is generally more common in elderly individuals, but can affect a person of any age. To diagnose dysphagia, your doctor might view your throat and esophagus with an X-ray. Another common diagnosis tool is a special tiny camera which explores the esophageal tube.[3] Treatments will vary depending on whether the swallowing difficultly is caused by blockage (such as a tumor) or improper functioning of the esophageal muscles.