People who have a hard time with pills should also stand or sit upright while taking it, ensuring the pill’s path won’t be a crooked one. “Try to psych yourself out with this pill swallowing mantra - ‘I can swallow this. “While it may seem as if you have an extraordinarily strong gag reflex or odd throat mannerisms, consider that it may actually be the power of your mind, not the power of your throat,” writes Alice of Go Ask Alice, Columbia University’s health Q&A service. In many cases, these serious complications won’t explain why people can’t withstand the foreign feeling of a baby aspirin falling down their throat. Dysphagia, a severe difficulty moving food from the mouth to the throat, can stem from neurological disorders (multiple sclerosis, Parkinson’s disease), neurological damage (from a stroke or spinal cord injury), pharyngeal diverticula (a small pouch that forms in the throat and collects obstructive food particles), or cancer. Given that it takes about 50 pairs of muscles and nerves just to swallow a tiny pill, difficulties swallowing can arise from a number of factors. Problems most commonly arise in the oral phase, as it is the only stage of the process controlled by the pill swallower. Finally, the esophageal phase pushes the food through the esophagus in order to reach the stomach for digestion. The pharyngeal phase includes closing the larynx, which prevents food from traveling down your windpipe. The oral phase involves wetting the food and chewing it in preparation for swallowing. Swallowing, ExplainedĬassivi notes that there are three stages to swallowing: oral, pharyngeal, and esophageal. ![]() The chalky texture of many pills - gel capsules are generally easier to swallow, Cassivi says - creates a disconnect between the body and mind, as the brain realizes the pill isn’t food but is asked to treat it that way. Some foods, like yogurt or applesauce, require no chewing at all. Gnawing off a large bite of food and swallowing it nearly whole is, for most people, not a worry - or at least not a trigger for the fear response. "We have an unconscious ability to know when food is moistened and masticated enough to be delivered to the back of the throat," he added, highlighting a complication that many people face. Overcoming that fear is a matter of concentrating effort on relaxing the muscles of the throat, Cassivi says. People may have had a particularly traumatizing episode where the pill slid too far back on the tongue without actually falling down the esophagus, so now they relive that moment on each future occasion. Often, the greatest difficulties come from a fear of gagging. The majority of people simply face mental barrier, which they could easily overcome if taking pills weren’t made into a grand performance. "People who have underlying swallowing difficulties, called dysphagia, may have trouble swallowing pills, but that is generally the result of other problems, such as stroke or surgery or gastroesophageal reflux," he told the Wall Street Journal. Stephen Cassivi, a thoracic surgeon at Mayo Clinic, says that his patients face the problem constantly. The resulting gagging or crying may be involuntary, but it’s hardly the reaction that many people would like to produce when facing an object the size of a breath mint. ![]() The problem of swallowing pills is compounded, in many cases, by feelings of immaturity. But swallowing pills doesn’t have to come with such side effects. The body naturally wants to break something down before it ingests it, so introducing a solid, not to mention ill-tasting, object has the tendency to make medicating more difficult. Whether it’s a dainty baby aspirin or a bulky horse pill, trying to swallow an object without chewing can make for a frustrating experience.
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