What should be done if a pill becomes stuck in the throat?

Management of a Pill Stuck in the Throat

If a pill becomes stuck in the throat, the first action should be to drink several large gulps of water while in an upright position to try to dislodge the pill and facilitate its passage into the stomach. 1

Immediate Management

1. For an actively stuck pill:

   • Maintain an upright position (sitting or standing)
   • Drink 1-2 full glasses of water in large gulps
   • Eat soft bread or banana which can help push the pill down
   • Avoid lying down immediately after taking pills

2. If the pill remains stuck after initial attempts:

   • Continue drinking fluids
   • Try eating soft foods to help push the pill down
   • Do not attempt to dislodge with fingers as this may push the pill further or cause trauma

3. Warning signs requiring immediate medical attention:

   • Difficulty breathing or stridor
   • Inability to swallow saliva
   • Severe pain
   • Drooling
   • Sensation of complete obstruction

Prevention of Pill-Related Esophageal Injury

Pill-induced esophageal injury is common and often preventable. More than 70 drugs have been reported to cause esophageal disorders, with antibiotics like doxycycline and tetracycline accounting for over 50% of cases 1.

Key preventive strategies:

• Take medications in an upright position (sitting or standing)
• Take pills with at least 100 mL (a full glass) of water
• Remain upright for at least 5 minutes after taking pills
• Avoid taking medications immediately before bedtime 2

Special Considerations for Difficult-to-Swallow Pills

For patients who regularly have difficulty swallowing pills:

1. Pill-swallowing techniques:

   • Place pill on tongue and take a sip of water
   • Tilt head forward (chin toward chest) when swallowing tablets
   • Tilt head backward when swallowing capsules
   • Use a straw to drink water, which can help focus swallowing 3

2. Alternative options:

   • Ask healthcare provider about liquid formulations
   • Inquire about different dosage forms (patches, sublingual tablets, etc.)
   • Consider commercially available pill-swallowing aids

3. Important caution: Never crush tablets or open capsules without consulting a healthcare provider or pharmacist. This can alter drug absorption, potentially causing overdose or underdose, and may destroy special coatings designed for sustained release or gastric protection 4.

When to Seek Medical Attention

Seek immediate medical attention if:

• Sensation of complete obstruction persists
• Chest pain, odynophagia (painful swallowing), or dysphagia (difficulty swallowing) develops
• Symptoms of esophageal injury appear (retrosternal pain, inability to swallow saliva)
• Breathing difficulties occur

Pill-induced esophagitis can occur even in healthy individuals who take medications with adequate water and in an upright position 5. Symptoms typically resolve within 2-7 days after discontinuing the offending medication 2.

Remember that prevention is the best approach to avoid pill-related esophageal complications. Taking medications with sufficient water while in an upright position significantly reduces the risk of pill entrapment in the esophagus.