This is not an uncommon problem. It’s estimated that one third of all people who have trouble taking medicine gag, choke or throw up when trying to swallow pills. As a result, they reduce their drug dosage or don’t take their medication at all, which can worsen or complicate medical conditions.
You may be able to solve your pill-taking problem with new approaches devised by a team of pharmacology researchers at the University of Heidelberg in Germany who tested the methods on 151 volunteers ages 18 to 85. More than half the volunteers had problems swallowing pills at the beginning of the test.
First, the researchers designed four shapes of tablets and capsules – including round, oval and oblong – in four different sizes for a total of 16 variations. None of the pills contained active ingredients, as the object was to test the ability of the study volunteers to swallow them. The investigators gave each of the volunteers the 16 test pills and asked them to close their eyes and try to swallow each one with 20 milliliters of water (a little more than half an ounce). The investigators ranked the pills based on the ease or difficulty the volunteers had in swallowing them. Not surprisingly, they had the most trouble with the “large” and “very large” sizes.
The study also tested two new pill-swallowing techniques, one developed for easier swallowing of tablets, the other for easier swallowing of capsules. For tablets, the method involved the use of a plastic water bottle. The participants were instructed to put a pill on their tongue and then close their lips around the mouth of a flexible plastic water bottle. Just as you would if you were taking a swig of water, the volunteers were told to keep their lips in contact with the bottle, purse their lips, and then use a sucking motion to bring the water into the mouth, When they swallowed the water, the pill went down, too. About two-thirds of the volunteers who had trouble swallowing tablets reported improvement with this method. Of those with no problems swallowing pills, the water bottle method made it easier for 71 percent to swallow the large tablets and for 64 percent to swallow the very large tablets.
The second method, called the “lean-forward” technique, was developed to make swallowing capsules easier. It involves placing a capsule on the tongue, taking a sip of water and, before swallowing, bending the head forward by tilting the chin toward the chest. Maintaining this head position, you swallow the pill and the water. The investigators reported that this worked even better than the water bottle method. All the volunteers who tried it with very large capsules said it was an improvement over the way they had previously swallowed the big pills. In addition, 91 percent of the volunteers who had no history of pill-swallowing problems said the lean-forward method helped with swallowing large capsules. Of those who had a history of problems swallowing pills, 82 percent said the lean-forward technique worked well. All told, 85.6 percent of the study volunteers said they would use the methods learned in the study regardless of whether or not they had past problems swallowing pills.
In short, pill-taking is a skill virtually anyone can learn if given the right technique.
Andrew Weil, M.D.
Walter E. Haefali et al, “Two Techniques to Make Swallowing Pills Easier.” Annals of Family Medicine, doi: 10.1370/afm.1693