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Summary

If swallowing pills, food or drink is difficult, there are tips to keep in mind which are discussed in this article under the following headings:

If the tips in this article do not help, tell your doctor. In case  your doctor doesn't think of it, consider asking if the form of the drug can be changed by compounding. With compounding, a drug which usually is sold in one form can be changed into another form. While the delivery system is different, the effect in the body is the same.  For example, a drug that is normally taken in pill form may be able to be changed into a wearable patch. You then absorb the drug from the patch through your skin. 

A swallowing problem could create an obstruction that interferes with your breathing. It is advisable for the people close to you to learn the Heimlich Maneuver to unblock the obstruction. Click here for information about how to do the maneuver. If there is an obstruction and a Heimlich doesn't work -  911 should be called immediately for help.

NOTE:

  • If you experience dry mouth, click here.
  • If you experience mouth sores, click here.
  • To learn how to keep your mouth, gums and throat healthy and prevent problems, click here.

Swallowing Pills

If swallowing pills is difficult, try the following tips:

  • Sit upright or stand when taking a pill.
    • Do not throw your head back when taking pills. (It can increase the risk of choking).
    • Consider tucking in your chin by lowering it slightly toward your chest.
    • Do not throw your head back when taking pills. (It can increase the risk of choking).
  • Swallow one pill at a time.
  • Take smaller pills if possible. If that doesn't work, consider trying larger pills.
  • Crush a pill and mix it with a substance to ease its movement such as apple sauce. (Check with your doctor or pharmacist before crushing a pill to find out if crushing is okay. Some pills lose their effectiveness if crushed.)
  • Moisten the mouth to help the pill go down more easily. For instance, take a sip of water just before taking a pill. 
    • If you take a few sips of liquid with or after each pill you will help prevent it from getting stuck in your asophagus.
    • Some people find carbonated drinks more effective than water in helping a pill go down. 
  • Ask your doctor or pharmacist if the medication can be taken in another form that is easier to swallow. For example, a liquid, a patch or through a needle. If they don't know about these alternatives, contact a compounder.
  • Try "effortful swallowing." This means consciously making each swallow more forceful than normal.
  • If the drug tastes bad:
    • You can numb your taste buds by sucking on some thing cold such as ice chips.
    • Conceal the unpleasant taste by putting pills into empty medicine capsules (available at drug stores and health food stores).
  • Review your list of medications with your doctor or pharmacist. Some drugs interfere with saliva and swallowing and may be the cause of the problem. If so, perhaps alternatives are available.

Swallowing Food Or Drink

Tips that have helped people swallow food or drink include the following:

General Tips To Help Swallow Food or Drink

  • Sit upright in a chair or stand. (Sitting in a chair is preferable to sitting in bed).
  • Take your time. Don't be rushed.
  • Try "effortful swallowing." This means consciously making each swallow more forceful than normal.
  • Consider tucking in your chin by lowering it slightly toward your chest.

Tips To Help When Swallowing Food Is Difficult

  • Limit bite sizes, for example, to one half inch or less.
  • Chew the bite well before swallowing. Some professionals use a rule of thumb that you should chew food until it becomes a mass of pasty consistency.
  • Swallow the bite before moving on to another. It may help to put down your eating utensils between bites as a reminder to swallow before moving on to the next bite.
  • Soft or liquid foods may be easier to swallow. For example: soups, cooked cereal, baby food, scrambled or fried eggs, cottage cheese, pasta (cut up).
  • Get nourishment in liquid form. For example, from milkshakes, smoothies or meal replacement beverages such as Ensure.
  • Watch for foods which have different consistencies. For example, cereal usually is consumed with both the cereal and milk in a single bite. You may do well with the solid food, but not the liquid. If this works, you can prepare foods for more consistency. For example, letting cereal sit in the liquid for a while to soften it before eating. Or you can blend or puree foods.
  • Avoid foods that could irritate sensitive tissues such as anything hot, spicy or acidic.Coarse, dry foods such as crackers or nuts might also be a problem. They can scratch the lining of the esophagus.

For recipes for easy to swallow foods, consider the following:

  • www.easytoswallow.co.uk offsite link
  • National Cancer Institute's: Eating Hints for Cancer Patients, Before, During & After Treatment, NIH Publication No. 03-2079, available for free at: http://www.cancer.gov/cancertopics/coping/eatinghints/page1 offsite link
  • Easy-to-Swallow, Easy-to-Chew Cookbook: Over 150 Tasty and Nutritious Recipes For People Who Have Difficulty Swallowing by Donna L. Weihofen, JoAnne Robbins, and Paula A. Sullivan, New York, John Wiley & Sons, Inc. 2002

If swallowing becomes so difficult that malnourishment occurs, an option is a feeding tube which can be inserted through the nose (nasgastric feeding tube) or a feeding tube that can be inserted through a small incision in the abdomen into the stomach (gastric feeding tube). Speak with your doctor.

Tips To Help When Swallowing Liquid Is Difficult

  • Limit the amount of liquid you take with each swallow.
  • Thicken thin fluids if necessary. Thickening fluids allows more time for throat muscles to do their job. Natural thickeners include cornstarch, flour (especially tapioca flour), instant potato flakes, oats.
  • Avoid liquids that could irritate sensitive tissues such as anything hot or acidic.

Tips about swallowing pills: Click here.

Foods And Drinks That Are Easy To Swallow

According to the National Cancer Institute, the following foods and drinks are easy to chew and swallow.

TypesFoods and Drinks
Main meals and other foods
  • Baby food
  • Casseroles
  • Chicken salad
  • Cooked refined cereals (such as Cream of Wheat®, Cream of Rice®, instant oatmeal, and grits)
  • Cottage cheese
  • Eggs (soft boiled or scrambled)
  • Egg salad
  • Macaroni and cheese
  • Mashed potatoes
  • Peanut butter, creamy
  • Pureed cooked foods
  • Soups
  • Stews
  • Tuna salad
  • Custard
Desserts and Snacks
  • Flan
  • Fruit (pureed or baby food)
  • Gelatin
  • Ice cream
  • Milkshakes
  • Puddings
  • Sherbet
  • Smoothies
  • Soft fruits (such as bananas or applesauce)
  • Sorbet
  • Yogurt (plain or vanilla)
Meal replacements and supplements
  • Instant breakfast drinks (such as Carnation® Instant Breakfast®)
  • Liquid meal replacements (such as Ensure®)
  • Clear nutrition supplements (such as Resource® Breeze, Carnation® Instant Breakfast® juice, and Enlive!®)

How To Do A Heimlich Maneuver

A Heimlich Maneuver By A Third Party

Basically, to do a Heimlich maneuver:

  • Stand behind the affected person.
  • Reach both hands around to the front of the person 
  • Place the thumb side of your fist just above the navel and below the rib cage.
  • Grasp your fist with the other hand.
  • Give a series of 4 quick inward thrusts.  This compresses the lungs and exerts pressure on any object lodged in the throat. The pressure causes the object to be expelled. 
  • Repeat the thrusts until the obstruction is removed. 
  • NOTE: Do not squeeze the ribcage. Confine the force of the thrust to your hands.

To do a Heimlich Maneuver on yourself

  • Make a fist and place the thumb side of your fist against your upper abdomen, below the ribcage and above the navel.
  • Grasp your fist with your other hand and press into your upper abdomen with a quick upward thrust.
  • Repeat until the object is expelled.

Alternatively, you can lean over a fixed horizontal object (table edge, chair, railing) and press your upper abdomen against the edge to produce a quick upward thrust. Repeat until the object is expelled.

 



If A Pill Tastes Bad

If a drug melts in your mouth and tastes bad, consider the following tips: 
  • You can numb your taste buds by sucking on something cold such as ice chips or a popsicle.
  • Conceal the unpleasant taste by putting pills into empty medicine capsules and then swallowing. Empty medicine capsules are available at drug stores and health food stores.
  • Find out if the drug comes in the form of a "drug patch" (transdermal drug-delivery system.) The medication's active ingredient is integrated into the adhesive gel on one side of the patch. When you wear the patch, the drug passes through the skin into your bloodstream.
  • Change the form by means of compounding. Drugs can be transformed into a different form, such as lozenge, gummy bears or even Popsicles or lollipops. All drugs are compoundable as long as there is not a patent on the form you need. To learn more, contact a compounder.