People with arthritis are often advised to take oral pain medication, but researchers estimate nearly 30% of people dislike or have difficulty swallowing pills. Some of these people say pills make them gag, or they feel like pills get stuck in their throats.
Doctors typically do not ask if patients have trouble swallowing medications, so it is often up to patients to raise the issue. Some patients can be helped with simple pill-swallowing techniques. Others, who have moderate to severe trouble swallowing pills, or who have trouble swallowing food as well as pills, may need to talk to their doctors about:
- Identifying the cause and treating the swallowing problem
- Potential pain medication alternatives
- Patients should never chew, break, or crush pills without consulting a physician or pharmacist
Most pills, tablets, and gelcaps are designed to be swallowed whole. Chewing, breaking, or crushing them can change how the medication is digested and absorbed into the body. This change can affect the way a medication works and increase the chance of drug-related problems or side effects. For example, taking an altered oral opioid medication can cause breathing problems or even a life-threatening overdose. (Alternatively, the altered drugs might stay in an inactive state, so that pain is left untreated.)
Dysphagia is the medical term for physical difficulty swallowing or the sensation of difficulty swallowing. (Odynophagia is the medical term for pain when swallowing. Some people with dysphagia also have odynophagia.)
Causes of Dysphagia
There are dozens of reasons people have difficulty swallowing, including:
- Neurological problems, such as Alzheimer’s disease, Parkinson’s disease, and stroke.
- Musculoskeletal conditions, such as Sjögren’s Syndrome, systemic scleroderma (sclerosis), spinal muscular atrophy, and severe anterior cervical osteophytes due to osteoarthritis.
- Previous surgeries, such as artificial cervical disc replacement or anterior cervical discectomy with fusion (ACDF).
- Metabolic syndromes, such as diabetes and hypo- and hyper-thyrodism.
- Certain cancers, such as brain, neck, and esophageal cancers, as well as cancer treatments, including radiation and chemotherapy.
- Gastroesophageal reflux disease (GERD), which left untreated, can cause esophageal spasms or scarring that can make swallowing difficult.
- Foreign bodies or food lodged in the throat or esophagus. In addition, people who have a condition called pharyngeal diverticula develop a small pouch in the throat that can fill up with food particles, making it hard to swallow.
Changes related to old age and other conditions, such as severe respiratory issues, can also lead to trouble swallowing. Sometimes the cause of dysphagia may remain unknown.
Talking to a Doctor About Trouble Swallowing
It is important have dysphagia acknowledged and addressed by a health care professional, particularly if it is interfering with taking medications, eating, or drinking. Trouble swallowing can put a person at risk for dehydration, malnutrition, and other problems, such as aspiration pneumonia.
Treatment for dysphagia depends on the underlying cause. Sometimes introducing swallowing exercises and techniques is effective. Other times medication or surgery may be used to treat the underlying condition.