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AshlynM's avatar

Is not being able to swallow pills all in your mind or is it really a physical problem with your body?

Asked by AshlynM (10542points) February 10th, 2012

I’ve always had difficulty swallowing any type of pills, even small ones. I’m amazed that some people can swallow horse pills whole and not choke on it.

I’ve always had to resort to crushing the pill and mixing it with applesauce. I feel kind of pathetic doing this because this feels like something you’d do for your children.

Does anyone else have problems swallowing pills, is it just me?

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41 Answers

janbb's avatar

My younger son does: it’s almost impossible to separate the mind/body causation.

JLeslie's avatar

It’s real, I have the same problem. I think it has to do with having a very strong gag reflex and also places in the back of tongue, throat area that pills get caught. Everyone I know who has problems swallowing pills has some similar things they complain about. it has been very upsetting and annoying at times in my life to be misunderstood about this, so feel understood here in our safe jelly haven. I have become better at swallowing pills as I got older, but it is still difficult.

lemming's avatar

Ya I did when I was younger. I’d say it’s completely in the mind, because we can all swallow food, right? And a mouthful is much bigger. When your going for it next, just commit to it and swallow like it’s food. You probably couldn’t choke even if you tried.

Mariah's avatar

If you’re able to eat normally, you probably swallow pieces bigger than those pills all the time. So I’d say it’s in the mind.

Aster's avatar

I think it’s all in the mind but we should consider that we’re used to chewing food before swallowing . Pills you don’t chew so it freaks little kids out. One reason they invented chewable vitamins for kids.

filmfann's avatar

I have a real issue swallowing pills. It is so bad, that I have to completely clear my mind to do it.
Funny thing: Often, I look at the table, and try to remember if I already took the pills.
So, for me, it’s all in my mind.

marinelife's avatar

When you think about how large pieces of food that you swallow are, you can see that it is a mind-body thing.

JLeslie's avatar

Well, I wound up on the emergency room when I took a prescription ibuprofen that did not go down. I didn’t want to take that big pill, but my husband was not having me spend money on candy coated Advils, when the script was free. I had heard it is in my mind from my dad my whole childhood, and “split it in half” more times than I can count. That big ol’ not coated ibuprofen laid in my esophogus while I slept, and I still have the photos of the huge ulcers taken by endoscopy at the hospital.

I have trouble sometimes taking teeny weeny pills like my thyroid pill, same size as a birth control pill more or less. I don’t worry I will choke on it, but sometimes it gets lodged in some crevice or something in the back of my throat. With BC pills, or vitmain pills that might be very small and not coated I can eat something to get it down, but thyroid medication is not absorbed if taken with food, so every so often when it happens, I wait a little for it to dissolve, and then drink plenty of water again, hoping I get most of the drug.

My gag reflex is so strong (and gag reflexes vary greatly, I think it is something like 30% of the population doesn’t have one, that would be you people who take 10 pills at once, can deep throat without worrying about puking on your partner, get a dental mold made up your upper teeth without worry they mixed the stuff too thin and it is running down the back of your throat, there must be other advantages) that I think it causes me to have my vomiting phobia, because throwing up can be almost painful it is so wrenching. Helped keep me from drinking and doing drugs as a kid, because I certainly did not want to puke from drinking, or from withdrawing if I ever got addicted.

Sorry if I sound abrasive, this topic is so upsetting, because we who suffer from the problem are so dismissed and it affects us more often than you would think. I do think for some it might be psychological, and for others it is a mix of psych and physiological. If, I am calm, and pkace the pill perfectly, I can usually get it down, usually, without something bad happening, but it is not easy if it is a larger pill.

And, by the way, my mom tells stories of me be little and choking all the time. I was upside down quite a few times. And, as an adult, I chew my food very well, and take smaller bites than most people I think. I am a slow eater. My husband eats so quickly, all I can figure is he does not chew as much as I do. I guess he doesn’t need to.

chyna's avatar

In my case, I think it was a mind thing. I had to get a piece of buttered bread, chew it up and right before swallowing, put the pill in the bread. This lasted until I was in my 30’s and then started taking a lot of vitamins. I just started taking them with water and got over it. Still, though, if I look at a large pill long enough and think about it, I sometimes still gag on them. It is better for me to just take them quick without thinking about it.

Adirondackwannabe's avatar

When I was young it was a little of each. I drank pipeline cleaner acid when I was little. Not really something I’d recommend. I had a litte trouble swallowing things for a while. It went away as I got bigger.

Dutchess_III's avatar

Drink a big gulp of water with it and you won’t even notice.

Dutchess_III's avatar

@Adirondackwannabe I’ve always wanted to meet an adult who did something like that as a kid! I mean, wasn’t there something in the smell that would have stopped you??

Adirondackwannabe's avatar

@Dutchess_III It was a pretty pink color and it was on a low shelf in the milkhouse, so I grabbed a big swig. That didn’t stay down so it got me both ways. My great grandmother was a nurse and happened to be at the house that day. Ahh good times.

WillWorkForChocolate's avatar

I think it can be a genuine physical issue. My husband has an incredibly difficult time swallowing even small pills, because his tonsils are absolutely ginormous. When people get tonsilitis and their tonsils are inflamed/enlarged? His tonsils are larger than that on a daily basis.

Dutchess_III's avatar

@WillWorkForChocolate Does he have a problem eating food?

Dutchess_III's avatar

@Adirondackwannabe Man…there was a three year who died last fall from drinking some sort of cleaner that some idiot had in WATER BOTTLE

Keep_on_running's avatar

In my experience it’s all in the mind. I used to be like you, could not even swallow the tiniest of pills. That’s because I was afraid of the pill; I treated it like something to be feared. My throat choked up (subconsciously or not) and I couldn’t swallow.

But when I looked at it like a small piece of food that I really wanted to eat, I just gave the biggest swallow. I treated my throat like a big muscle capable of expanding as much as I let it.

I don’t have any problem with pills anymore; it’s so easy and that’s because I’m confident and blah, blah, blah. This sounds so stupid, but it’s honestly true. I don’t think from the time I was unable to swallow pills to now where I can down any sized ones that my throat “miraculously” grew bigger or something. It’s psychological.

Adirondackwannabe's avatar

@Dutchess_III That sucks. It wasn’t really my families fault that the barn wasn’t childproof. I was the oldest male and first child to spend much time in the barn and I was always curious. But to have it in a water bottle is nuts.
AshlynM is going to hate me after the last two days so back to swallowing pills.

WillWorkForChocolate's avatar

@Dutchess_III He does sometimes, yes. He has to chew his food into tiny little pieces before attempting to swallow it.

JLeslie's avatar

Guess I have to take back feeling safe, most jellies on the Q have the same answer as probably most people in your life, all in your head. Dissappointing. Even if it is all in our head, which I do not agree with for a second is true in all cases obviously, it is still real, and can be dangerous. People who have heart attacks from stress, the stress is created in their head, but the result can be life threatening. I think accomodate your problem with swallowing, ask for liquid medicine (always measure with a proper measuring tool) and chewables. There are more and more vitamins and medications coming out for people with swallowing difficulties. Thank goodness.

GracieT's avatar

When I was little I couldn’t swallow pills- even little ones. I remember my parents having to crush up even the smallest ones. As I got older that stopped and I could swallow them. Which was lucky because now I’m on 7 meds for the rest of my life. I’m only 42 so that number may change! Now I have to act like I’m chewing them first, even though I’m not. Surprisingly enough it works!

JLeslie's avatar

@GracieT What if the pills fall apart fast? Can you swallow quickly if you have to? Metronidazole, Levoxil, several generics are not coated or barely coated, and there is no time to play around to set up the pill for an easy swallow. This is one of my biggest complaints. Capsules are obviously much easier.

zensky's avatar

Stick it in a little piece of bread.

JLeslie's avatar

Some drugs must be taken on an empty stomach.

GracieT's avatar

@JLeslie, it has (does!) happen to me also! When it does, water is my best friend! I have to drink it often when I take meds anyway, so it’s
really not all that different.
BTW- even though they still taste disgusting, when you aren’t convincing yourself to be afraid of them they aren’t that bad for that long!

JLeslie's avatar

@GracieT I can do it, it just is nerve racking.

SpatzieLover's avatar

@AshlynM This is a common problem with people that have oral defensive issues either due to sensory issues or due to a strong gag reflex.

My husband just learned how to swallow pills recently at about age 31. My son has a hyper-sensitivity sensory disorder, yet can swallow pills with ease (since age 5).

Some of the issue is in your mind. Some of the issue may be due to some other physical reason.

My best suggestion is to either begin by swallowing TicTacs or M&Ms then move to a small supplement. After you have these mastered, you should be able to swallow most pills. If swallowing the candy is difficult with water, try swallowing one piece in a spoonful of pudding or yogurt. Then move to the water.

Try to gain success in small increments. Don’t mentally beat yourself up over this.

muppetish's avatar

I’m also a late-learner when it comes to swallowing pills. I have a bad gag reflex and when I began to try taking pills, I would get extremely frustrated in my inability to swallow them, which made the process even worse. I ended up taking the tiniest of pills with a ton of water. Now I can swallow several pills at time without thinking too much about it.

The absolute worst was when I was in middle school and needed to take penicillin. Since I couldn’t swallow pills, I had to take it in liquid form. God, that stuff tastes disgusting.

likipie's avatar

I don’t think it’s been proven either way. It’s kind of an “interpret it how you will” scenario.

LezboPirate's avatar

I have that same problem. I’ve finally managed to get the very small pills down without choking or gagging. Luckily I don’t take pill very often. Almost never.

Pandora's avatar

In my case it was mind over matter. As a child I choked on a few hard candies and so I was afraid any time I was required to swallow anything large. I know part of the problem was that I would freak out so much that my throat would clamp up and even the smallest pill had to squeeze through. Then I saw video on the discovery channel or something like that about the mechanics of swallowing and how and why it is actually so easy for us to swallow and how our body protects us from swallowing down the wrong way.
It works like a slip and slide.
Here’s some ideas in helping you learn to swallow
I started with the method of putting the pill way in the back but then I found that if I placed the pill close to the front of my mouth and then took a medium amount of water in my mouth that the pills would simply float down. I would also concentrate on something pleasant to look at. After a while, I found I didn’t think about it at all.

augustlan's avatar

I don’t think anyone really knows, but it shouldn’t matter. If it’s a problem, it’s a problem, you know? I’ve mostly mastered my issues, by ‘floating’ the pills down my throat. Still, every once in a while… I end up having to cough the pills up out of my throat, where they are stuck. :/

YARNLADY's avatar

The gag reflex is physical, but can be overcome by practice. You need to learn to relax the tongue. To me, it is very similar to learning to whistle, or hold your breath.

Paradox25's avatar

I can’t swallow pills even if my life depended on it. I’ve tried to swallow then on quite a few occasions and I either gag (sometimes nearly choke) or they feel like they’re stuck in my throat for the next 24 hours no matter how much water I drink. I have to rough it and chew them, which at times is horrible depending on the type of medication I’m taking. Bitter pill face bitter pill face :o( I still think that it is mental, and I think that the stress probably constricts my throat muscles.

sliceswiththings's avatar

I think mental, since I got over it. I found it helpful to put the entire pill into a spoonful of yogurt, it went right down the hatch! Then I started taking birth control, and although their tiny I got used to the swallowing sensation since I was doing it every day, and I now swallow those pills dry. I agree with @lemming, rather than trying to ignore the pill and just drink water normally, I find it easier to acknowledge the pill and consciously swallow it. But in the meantime, just take a bite of any food, chew it up without swallowing it, stick the pill in your mouth, and swallow everything!

Buttonstc's avatar


What a horrifying experience. Ibuprofen is rough stuff. I learned that my stomach cannot tolerate Ibuprofen plus any cola drink simultaneously. Like battery acid. Awful.

To answer the Q. No it’s seldom ALL in your head.

For those who state that for them it is can ONLY speak for their own experience. They cannot extrapolate that to anyone else on the planet and refuse to listen to them. Their experience is their own. They have no right to dictate to you that their experience should be yours. Don’t should all over yourself. And don’t allow anyone else to do it either. Just tell them MYOB.

I got an interesting perspective on this when a dentist needed to take a mold of my teeth for a bite plate.

He had to send the assistant out to fetch a pediatric tray since my mouth (jaw) was so small. I’m an adult. Obviously with a smaller mouth than average.

That has nothing to do with the mind. My jaw doesn’t need a pediatric tray because I think it does. It’s simple physical measurement.

Stands to reason the rest of me (esophagus included) is smaller, narrower than average.

Stop listening to those who keep insisting you should be able to swallow pills like they do.

Here’s some practical advice. The only types of pills which absolutely MUST BE swallowed whole are time release formulations since splitting/crushing them gives you the entire dose at once.

Ask for the regular formulation. Big deal. So you have to take it 4X per day rather than once or twice. So what? Who cares other than you?

Gelatin caps have two possibilities. The really large ones (like 500 mg Amoxicillin) can usually be taken apart and the contents mixed with baby food/yogurt/pudding etc. and swallowed.

Smaller ones, I usually let them sit in my mouth along with a mouthful of liquid until both warm up to the temp in my mouth and begin to soften. Then I flatten them by pressing them against the roof of my mouth with my tongue. It narrows them enough to enable swallowing more easily. Or dump the contents into something like the large ones.

For most other pills, a pill splitter does the trick. For an oblong tab, into four pieces usually does the trick. But I still have to crunch that ¼ pill with my front teeth into smaller pieces before swallowing. Some taste bitter. But FOR ME it’s better than getting it stuck halfway where it’s still bitter but takes longer to dissolve.

And for larger ones like Bactrim (an antibiotic) I have to chop into eight pieces. Is that ridiculous? Only to someone minding my business rather than their own. MYOB.

For me, eight pieces for a Bactrim are the way to get the job done. So what?

Enteric coated pills are the other category for which splitting doesn’t work for obvious reasons. I don’t take those. If I need the active ingredient and it’s rough on the stomach that’s when I take with milk.

Those are my solutions which work for me. You may find them helpful or find your own solutions. I have about half a dozen pill splitters at home and in my purse/pockets and use them regularly. But I also don’t hesitate to crush something when necessary.

You do what you need to do to cope with the situation. If you can’t swallow pills without them getting stuck halfway then you can’t. So you figure out how to deal with it. It’s your mouth and your medication. You don’t owe an apology to anyone for HOW you solve the problem.

They don’t get a vote. It’s your body. Period. Don’t be afraid to stick up for yourself in order to do what you need to do.

What anybody else thinks of it is totally irrelevant. There’s NOTHING to be embarrassed about. Solve the problem any way which works for you. Ignore the rest.

If you’re ever in the hospital, this applies to nurses, Drs. as well. They are medical professionals. It’s part of their professional job description to accomodate your reasonable requests regarding this.

It’s not up to you to accomodate them. They are the professionals. Let THEM deal with it.

So if it means that the nurse may need to spend an extra 5 mins. while you do your thing, so be it. Most times they need to watch the patient actually take the meds.

So it takes a little longer for you. Big hairy deal. So what?It’s a few extra mins. Get over it. It’s your job as a medical professional. Deal with it already.

Eleanor Roosevelt had an interesting quote: “no one can insult you without your permission”

The exact same principle applies. No one can embarrass /intimidate you without YOUR permission. Don’t give it. Plain and simple.

There is simply nothing to feel embarrassed about if you have difficulty swallowing. You owe an apology to no one. Stick up for yourself for no one else is going to.

(this goes for you also, JLeslie. What your husband did was inexcusable. It was coercive, plain and simple. And you paid the price for it, not him and you have the XRays to prove it.) I sure hope you have a copy of those XRays to shove under the nose of any medical professional (or anyone else) foolish enough to be coercive about the issue.

This ain’t rocket science here. Do whatever you need to solve the problem and get on with the rest of life

augustlan's avatar

@Buttonstc makes a good point. I also have a small mouth and esophagus, needing pediatric sized mouth trays and even a pediatric sized breathing tube when I have surgery. It seems logical that people like us would have a harder time swallowing pills.

JLeslie's avatar

@Buttonstc I take ibuprofen without worry for years. I always take coated that goes down easy, and OTC, so they are smaller pills, with plenty of water and some food. That ibuprofen would have burned a hole in anyones esophagus if it had laid there, thing is most people easily get the pill down to their tummy. In fact, as a side note, people who say they can’t take the drug because they developed stomach ulcers, when I ask them if they drank plenty of water and ate when they took it, they either aren’t sure or didn’t, but most are too afraid to try it again, because their doctor told them they shouldn’t. Thank goodness the Gastro doc who did my scope told me the precautions I should take, and did not say I could never take the drug again. Once in a while a doctor thinks about what occurred, all the factors.

john65pennington's avatar

I think it is purely psychological.

Try this next time: put the pills in your mouth with a medium amount of water and then look up to the blue heavens, then swallow. Looking at the sky somehow is a distraction in my brain.

This may sound a little absurd, but it works for me.

GracieT's avatar

@john65pennington, raising my head looking at the sky helps. I think it is because it helps me swallow.

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