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Difficulty In Swallowing

Why are tablets so hard to swallow?

There are lots of reasons why tablets or capsules (solid medicines) can be difficult to swallow. Some people just gag at the thought of swallowing a tablet, others have a dry mouth, some patients have illnesses or are taking medications which can affect swallowing and in the case of children some are just too young to want to swallow something solid.

What is Dysphagia or Swallowing Difficulties?

Swallowing difficulties are often called dysphagia by healthcare professionals. Simple Dysphagia Definition: Dys means difficulty and phagia means swallowing. It can feel like something sticking in the back of your throat or chest whilst trying to swallow.

What is dysphagia?
The process of swallowing prevents food/drink/medicines from entering the airway rather than the stomach. The term dysphagia is used by healthcare professionals to describe swallowing difficulties. Dysphagia (swallowing difficulties) can happen at any stage of swallowing from the time food/drink/medicines enter the mouth until it reaches the stomach.

What are the symptoms of dysphagia?
One of the main symptoms of dysphagia is choking and /or coughing when trying to swallow. Other symptoms of swallowing difficulties include shortness of breath when trying to swallow and regurgitation. The voice may also sound bubbly.

What causes dysphagia?
Swallowing difficulties can be due to many different reasons. These include having a dry mouth, so there isn’t enough saliva to help the process of swallowing; a number of neurological conditions can make swallowing difficult like Parkinson’s disease, Multiple Sclerosis and Motor Neurone disease. After having a stroke many people have difficulty with swallowing. Also, some medicines can lead to swallowing difficulties as a side effect.

The definition of dysphagia
‘Dys’ means difficulty and ‘phagia’ means swallowing. Dysphagia can therefore be defined as ‘swallowing difficulties’.

Symptoms of Dysphagia with Medicines

If any of the following apply to you or someone you are caring for, let your doctor, nurse or pharmacist know, so that an alternative formulation can be prescribed. Sometimes I:

  • find it hard to swallow tablets or capsules
  • don’t take my medicine because I can’t face swallowing it
  • need to crush my tablets or open capsules to make them easier to swallow
  • need to break my tablet into smaller pieces so I can take it
  • mix my medicine with food or drink to make it easier to take
  • need to suck or chew my medicine before I can swallow it

Who has difficulty swallowing tablets or capsules?

Young and old alike may find tablets or capsules hard to swallow, but some people are more likely to find it difficult than others:

Older people – around 60% of people over 60 have struggled to take solid medicines like tablets or capsules at some time [1]

Dry mouth –getting older can mean less saliva in the mouth which makes swallowing tablets more difficult. Also some medicines can cause mouth dryness.

Stroke – after having a stroke, many people have swallowing difficulties at least for the first few months. In the early stages of stroke, nearly 80% of patients will have some sort of swallowing problem [2]

Other diseases – such as Parkinson’s, Alzheimer’s and Motor Neurone disease can all affect a person’s ability to swallow solid medicines, for example around 50% of people with Parkinson’s disease will have some difficulty with swallowing [3]

Diabetes – people with long term diabetes may develop some degree of swallowing problems

Throat or neck problems - tumours or radiotherapy in this area can lead to swallowing difficulties

Children – there is no set age at which children are able to swallow solid medicines, but some can struggle until they reach their early teens and even beyond!

But remember, you don’t need to have anything wrong with you to find swallowing tablets or capsules difficult.

Making children’s medicines easier to swallow

Children often don’t like taking medicine and there is no set age when they can happily swallow solid tablets or capsules. Generally younger children will prefer a liquid medicine to taking tablets or capsules, as liquid medicines come in different flavours and are easy to swallow.

Most tablets are designed to be taken by adults and as children are smaller and lighter, it’s not always easy to get an accurate dose of medicine for a child from a solid tablet. A liquid medicine can provide a wide range of accurate doses for a child, without the need to try and cut tablets in half or even quarters!

If your child is prescribed a tablet or capsule which they are having problems swallowing, don’t be tempted to crush it or add the contents to food or drink to make it easier to take, unless the patient information leaflet which comes with the medicine says that it is alright to do so. Ask your pharmacist, doctor or nurse for a suitable alternative such as a liquid medicine instead.