Difficulty Swallowing Pills: Causes, Tips & Resources

Question
I am having difficulty swallowing pills. I never had difficulty swallowing pills with water up until now. Do you have any tips for me? Thank you very much. Al Brown

Answer
Hello Al,

Difficulty swallowing or dysphasia, is common.  The problem is is that it can be completely benign, or indicative of a serious problem.  Certainly, the benign causes are more common.  After reading your question I looked on the Internet and found an interesting site: http://www.dysphagia.com/  I think that it's worth your taking a look at.

As far as technique goes, sometimes ingesting pills with water is not satisfactory because of the thin nature of water.  Ingesting your pills with a more viscous solution such as milk will most likely be much more comfortable.  Also, a trick that the speech therapist's use in the hospital is using carbonated soda such as seven up.  7-Up seems like it would be a thin solution, but the carbonation actually makes it swallowed in sections.  It becomes one of the safer beverages, because of that.

Certainly, I don't want to alarm you but you should beware that swallowing difficulties can be suggestive of more significant problems.  The worst of course, would be ALS.  Difficulty swallowing or dysphasia in ALS happens later in the course of the illness.  That is reassuring because these are your initial symptoms.  

The other concern it that it might be a cerebrovascular accident or small stroke.  Small strokes are notorious for causing speech and swallowing difficulties.  You may ask your physician their opinion is on this.  Also he might consider, if you have had any associated neurologic changes with the dysphasia.

With the onset of this problemroot abrupt Mr. Brown?  Can you think of any other symptoms that arose at the same time?  Were you ill at the time?  Perhaps you could describe the problem more specifically regarding if there is pain with swallowing or if you've had a history of swallowing problems, or if this is indeed a new problem.  Also please comment on the duration and onset, and the overall impact it's having upon you.

If you were interested, you might address these points and send me another e-mail.  I would be happy to follow up.

Thank you for the question.

Dr. T