When it comes to consuming food or pills, it all starts in the tongue! The tongue acts as a “gatekeeper” by helping us distinguish between good and noxious substances and consequently guiding our food choices. Although simple in appearance, the tongue is an intricate organ with thousands of taste buds – small structures that mostly reside on papillae (or raised bumps) on the upper surface of the tongue and on the palate . Each taste bud harbors a set of 50 to 100 specialized cells known as taste receptor cells responsible for either sensing different tastes or mediating biological processes following taste detection. 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. 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.
How to swallow a pill
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.
The pop-bottle method is designed for swallowing tablets:
Step 1: Fill a plastic water or soda bottle with water.
Step 2: Put the tablet on your tongue and close your lips tightly around the bottle opening.
Step 3: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:
Step 1: Put a capsule on your tongue.
Step 2: Take a sip of water but don’t swallow.
Step 3:Tilt your chin toward your chest.
Step 4: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.
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:
Step 1: Put a pill in applesauce or pudding. The texture can make it easier to swallow pills whole.
Step 2: Grind a pill into a powder and add it to applesauce or pudding.
Step 3: 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.
How to Safely Swallow Large Tablets and Capsules
Tilting Your Head Down
One tip is to try tilting your head down. While most of us assume that we should tilt our heads back in order to help us swallow the water and tablet, the reality is that doing this actually causes the esophagus to close up and the trachea to open! So instead, try tilting your head forward and you will force close the windpipe and open up your gullet. This will help the pill to slide down more easily!
Grinding and Splitting
Another option is to grind your pill down or to split it in half. However, it’s important to make sure you can split a pill safely before you give it a try. The best way to find this out is to discuss with your doctor but another clue might be if the pill is scored down the middle. Sometimes this is also encouraged in order to enable the user to take a lower dose of the given medication.
Problems can emerge however if pill splitting damages an external coating that is designed to slow the release of active ingredients, or if it results in an incorrect dosage. This is why it’s very important to check with your doctor before you go ahead.
If it turns out you can split your pill, then you might also want to consider grinding it. Many pills that can be split can also be ground up and added to a yogurt or sandwich to make it that much more palatable.
The Pop Bottle Method
Another option is to try a technique referred to as the ‘Pop Bottle’ method, based on research conducted by the University of Heidelberg in Germany. In the study, it was found that this method led to an improvement of 60% versus the traditional method.
To try the pop bottle method for yourself, first fill a plastic water bottle and then place the tablet on your tongue as normal. Now close your lips around the bottle opening and take a gulp using a sucking motion without letting any air into the bottle or your mouth.
How to swallow a pill for a kids
Typically, children can begin swallowing pills around the age of 10; however, some children as young as 5 or 6 can learn to swallow pills. You can help your child learn how to swallow pills by using what every kid loves: candy. One of the easiest ways to teach your child to swallow pills is to practice with small candies, such as sprinkles, and progress to larger candies, such as Tic Tacs or jelly beans. To get started, get your child to follow these steps:
Step 1: Swallow a sip of water or their favorite drink.
Step 2: Place the smallest candy sprinkle on the middle of their tongue.
Step 3: Take another sip of the drink.
Step 4: Keep their head level.
Step 5: Swallow the drink with the candy.
Step 6: Take another sip to keep the candy moving.
Encourage your child to keep drinking if the candy does not go down in the first swallow. Children may need to practice many times with the same size candy before moving to the next size. Help your child understand that it is normal for them to feel the “pill” in their throat. The more they practice, the easier it will become. Always end each session on a success by making sure the last “pill” is swallowed, even if that means moving back to a smaller size.
If your child is struggling with learning this skill, try some of these tips:
- Try carbonated and non-carbonated drinks, and try the drinks warm, room temperature or cold.
- Use a straw to drink.
- Place the candy on different areas of the tongue before taking big gulps of the drink.
- Stand up or sit up straight.
- Take a drink without swallowing before putting the candy in the mouth.
- Try different types of foods to swallow the candy, such as apple sauce, Jell-O, yogurt, pudding, ice cream or milkshakes. You should always check with your physician or pharmacist before your child takes medications with food to make sure it’s OK.