Swallow a Pill

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While it seems like an easy task, swallowing a pill is something that many adults as well as children have great difficulty doing. The fear of gagging can cause the throat to tighten up so that pill stays in your mouth until you spit it out. Fortunately, there are various ways to approach the problem so that you can relax, overcome the fear of choking, and just let the pill easily slide down. It's like riding a bike - once you get the hang of it, it becomes second nature.

Step 1  

Find the baking section of a grocery store and purchase five candy decorations of various sizes. The smallest can be sprinkles, while the largest should mimic the size of the pill that will need to be swallowed (e.g. breath mints).

Step 2  

Sit down with a glass of water and relax. Do whatever you can to ease any anxiety, such as finding a quiet place, listening to music that calms you, or meditating. This will help soothe your nerves and break the association of pill time being stressful, so your body will be less likely to gag. Gagging is a natural response to the fear of choking, so in all likelihood, it's all in your head (unless you have dysphagia; see Warnings below). Use visualization techniques (e.g. imagine yourself swallowing a pill without a problem) and/or mantras (e.g. "I can swallow a pill easily.") to overcome psychological obstacles to swallowing a pill.

Step 3  

Numb your throat by spraying or gargling an over-the-counter topical anesthetic (normally used for sore throats).

Step 4  

Salivate. If you find your mouth getting dry, this will not help you swallow the pill. You can salivate by imagining yourself eating your favorite food, taking a sip of water or rubbing your tounge quickly side to side between the frontal lower lip and your teeth. Some people find it helpful to drink a swallow of water just before putting the pill into their mouth.

Step 5  

Take a deep breath. This may help to suppress the gag reflex. At the very least, it will probably help you relax.

Step 6  

Place the smallest candy on your tongue, as if it were a pill. Some people place it on the front of the tongue, while others place it on the back, near the throat (but not too close, or your fingers might trigger the gag reflex). Just before placing the pill in your mouth, breathe in slightly and hold it. This can give you the security of knowing you can cough out the pill if you feel it may get stuck.  

  • Make sure you place it in the center rather than to the right or your left, especially if you are going to be swallowing an oval-shaped pill (such as a vitamin). An oval-shaped pill should be placed so that the length is parallel to your throat. Otherwise, the pill may go into the throat "sideways" and create discomfort. 

Step 7  

Immediately take a sip of water and wash the pill directly into your throat. Take a few additional gulps after the pill is in your throat to help it move down.  

  • The water should be cool but not cold.
  • You can also use juice or grape drink, but check to make sure that the juice will not conflict with the medication you're taking. Drinking a carbonated beverage straight from the bottle may also prove helpful, possibly because the bubbles make the pill not as easy to detect and the motion of throwing your head back when drinking from the bottle can help the pill go down.
  • An alternative is to use this technique with food instead of fluid. Just chew the food, then place the pill in your mouth (in the food) and swallow. As with juice, check to make sure that the food will not conflict with the medication you're taking. Some medications need to be taken on an empty stomach.
  • For some people, using a straw to drink the water or beverage helps because the suction used to pull the liquid through the straw makes it easier to swallow the pill.

Step 8  

Put your chin to your chest; lifting your chin up and looking at the ceiling while swallowing will open your trachea (wind pipe) and close your esophagus, which is the opposite of what you want to do. This also helps stifle the gag reflex. Looking down while holding your breath works even better!

Step 9  

Follow up with food. Provided that the medication does not need to be taken on an empty stomach, you can eat immediately after swallowing the pill to help it go down.

Step 10  

Repeat until you feel comfortable with the process. Then move up to the next size of candy until you feel comfortable with that. Practice every day for about 10 minutes until you're swallowing a piece of candy that's the same size and shape of the pill you need to take.

Tips

  • Many people find these alternate methods helpful:

    • Taking a pill can be a completely mental problem. Putting the pill in food can really help trick the mind to thinking that it is just a part of the food. One idea is to make a quesadilla, then placing the pill in the quesadilla, taking a few bites and swallowing them without too much chewing to prepare yourself, then taking a bite with the pill in it, chewing the food around where the pill is and then swallowing it all together. This process can also be done with bread or other solid foods that are soft. After taking the pill like this for a while, your throat should get used to the feeling of the pill go down and eventually you can take the training wheels off and take it solely with water.
    • Fill a glass with either regular milk or chocolate milk. Take a sip, then place the pill into your mouth. Visualize yourself slurping down the rest of a bowl of ice cream, and the pill is only a chocolate chip.
    • Fill a soda bottle about halfway. When you tilt the soda bottle up, it can help in three ways. First: the water is following the path of gravity. Second: it can straighten your mouth/throat to make a "clear path." Third: It gives you a healthy supply of water to make sure it goes all the way down.
    • Talk yourself out of what could be frightening you. You eat whole chunks of other food without worrying about choking. Tell yourself you are drinking a glass of water and pretend the pill is not there. Chug-a-lug the drink and if the pill(s) go(es) only half way keep drinking even if you swallow air.
    • Fill your mouth up with liquid, hold your head back and open your mouth and drop the pill in your mouth with liquid still in it. Then close your mouth, bring your head back to a normal position and swallow; this will be like drinking a beverage. Almost any size pill can be easily swallowed with this trick. When doing this trick, it may help to squeeze your nose. Don't try to swallow with your head back. Physically, your esophagus cannot perform it's job of swallow in that position. You would do better with your face in normal position or chin slightly down.
    • Take a slice of bread, chew it thoroughly in your mouth until it becomes a soft mass, and simply shoving the pill into the soft bread mass. Since you have no trouble swallowing chewed bread, and the pill never comes in contact with your mouth at all, it is very easy to swallow the entire soft mass with the pill inside it as if you were just swallowing some chewed bread. Of course many other foods work as well.
    • Put the pill in your mouth, take a large sip of whatever liquid you are using, swirl the pill around in the liquid to eliminate dry spots that can stick to your throat and then swallow. Always follow up with more liquid.
    • Some people also find that a sort of ritual like crossing their fingers, breathing in before swallowing, or even just blinking help them swallow the pill. You may want to consider finding your own ritual to do before or during the time when you swallow the pill.
    • Take a sip of a carbonated beverage after putting the pill in your mouth. The carbonation floats the pill and you can easily swallow it, because your mouth and throat don't even know it's there.
    • Take a mini-marshmallow, rip it in half and wrap it around the pill. Stick it in your mouth for a second or two to get it moist. It should be very easy to swallow.
    • Try using a spoonful of jam or jelly to help you swallow the pill. Get a spoonful of jam or jelly, put the pill in it, and swallow the whole thing. Since it's sweet, it will mask any bad flavor, and jelly is slimy and goes right down. You could also use pudding.
    • Practice having a drink with crumbs of biscuit in your mouth - as if you are just washing your food down.
    • Pretend that you do not have a tablet in your mouth and just take a drink as you would do normally.
    • Place the tablet inside the neck of a half full soda bottle. When you drink from the bottle, the pill should go down with the water.
    • Swallowing a pill with apple sauce is also a good way to swallow it.
  • Swallowing is a natural process, you do it every time you drink or eat. This is no different. You just have to convince your brain that it's alright to swallow.
  • Minimize the time that the pill spends sitting on your tongue. When practicing with candy, you shouldn't give your mouth time to actually taste it because when you eventually move up to a real pill, the unpleasant flavor could make you gag. Get in the habit of putting the pill on your tongue and drinking the water in one swift, smooth motion.
  • Try to buy pills that are coated. They slide down more easily and are less likely to taste bad if they sit on your tongue longer than they should.
  • Take a sip of water before swallowing the pill. The added moisture in the mouth prevents the pill from sticking to the tongue.
  • Try drinking it with an iced soda or something with flavor. It masks the taste of the pill. Though with some medicinal pills they cannot be taken with soft drinks or juices. Ask your doctor if you have any concerns.
  • Dairy products may be recommended for some medications but something more liquid may make the swallowing faster.
  • Explain to children that taking a pill tastes better than swallowing a syrup or liquid version of a medication.
  • Tell children to "float" the pill like a boat in their mouth and then tell them to swallow.
  • Check the label. Some pills are meant to be chewed. These are usually the larger ones with special flavoring. This may be a gentle step to introducing children to pills.
  • Consider using a water bottle to swallow pills. The pressure created by squeezing the bottle can create flow that carries the pill along with its momentum.
  • You might try using yogurt instead of water. The firmness of the yogurt pushes the pill right down.
  • Since capsules (as opposed to solid pills) float, tipping your head down to swallow them works with buoyancy to carry it down your throat. Heavy solid pills can be swallowed with your chin up, but don't fling your head back, gently tilt it. By the time you take the gulp of water that is already in your mouth, the pill will have gone down first.
  • Try getting used to swallowing cooked macaroni in mac and cheese. If you can't get it down at first, chew it once or twice. Eventually, work up to swallowing one or two whole macaroni (still cooked, of course), then try for the small candies. This will get you used to the feeling of something going down.
  • A Banana, slightly chewed up in your mouth can work as a substiture for water.

Warnings

  • Some pills require you don't lean back when you swallow. Check with your pharmacist about everything!
  • Always check with a doctor or pharmacist about swallowing a pill with anything but water. There are many medications which lose their effectiveness (or even create unpleasant side effects) when mixed with certain beverages or foods. Some antibiotics, for example, should never be mixed with dairy products.
  • If you have a tendency to choke on liquids, there are tasteless thickeners available (at your drug store), which you can use to thicken liquids slightly or to honey thickness. If you feel you need the thickener, be sure to check with your doctor to rule out any condition which would cause you to have problems swallowing.
  • Do not take a pill when lying down. Sit or stand up.
  • If you still have severe difficulty swallowing pills, you may have dysphagia, a swallowing disorder. Ask your doctor about it. It's important to remember, however, the people with dysphagia also have difficulty swallowing food, not just pills.
  • Do not cut or break the pill in half to make it smaller. This may interrupt the way the pill is supposed to dissolve in your stomach. It could also make the pill taste even worse, and the jagged edges may scratch your throat.
  • Some pills are specially coated for time release. Breaking one of these can cause the pill to release its concentration faster. You should be especially careful never to split or crush a time-release pill.
  • Keep all pills out of the reach of children. Many special flavors have been created to make pills taste better (fruit flavored vitamins, sugar coating on Advil, etc.) Children often seek out these tastes, consuming them for an accidental overdose. Never tell children that pills are candy.
  • Throwing your head back also gives a straight shot to your "windpipe". It is safer to keep your head straight or even tip it forward to block your airway.

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