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Dr. George: When Swallowed Pills Get Stuck
Published in the Ojai Valley News, October 11, 1991, p. B-5.
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Dear Dr. Meinig:
I take a fair number of prescription and vitamin tablets and capsules. Occasionally I have had one get stuck. Eventually it seems to disappear but I have been concerned that it might cause problems. Any suggestions? – C.S.
Dear C.S.:
The tube or pipe that food travels down on its way to the stomach is called the esophagus. Pills rarely become stuck in it but it does happen. This is more likely to occur when several tablets or capsules are swallowed at one time, or when a person lies down immediately after swallowing the pill. Individuals who are on medication that cause mouth dryness are more apt to have this problem.
Gelatin capsules [can] soften and become sticky shortly after becoming wet. Dry tablets can also stick to the inner wall of the tube. If they do, and the substance is of an acid or alkaline nature, it could cause an irritation or inflammation called esophagitis. Should a burning sensation occur, it would be well to drink a baking soda solution.
If you are prone to this problem, the following will help to prevent its occurrence:
- Before taking the pill, sip some water to lubricate the esophagus. Also, drink some afterwards.
- If the tablets are not of the time-release variety, cut them in half or powder them. If you don’t know if they are the slow release type, ask your pharmacist or doctor. The time-release feature is destroyed if the tablets are cut.
- After taking the pill, remain standing for a couple of minutes to allow gravity flow to complete its passage to the stomach.
- If you are confined to bed and can’t sit up, see if what you are taking can be obtained in liquid form.
- If a pill becomes stuck, stand up and drink some additional water or liquid. Should water not be available, eating a banana or almost any food can help dislodge the stuck pill.
- Food itself can become stuck in the esophagus. The same procedures mentioned above can help resolve the problem.
The Heimlich Maneuver
When a piece of food or a pill becomes caught in the throat, it is entirely a different matter. This can be very serious and cause death in but a short period of time. Because the obstruction blocks the passage of air into the lungs, the person can become unconscious quite quickly, their skin becomes blue in color.
Dr. Harry J. Heimlich, a thoracic surgeon, devised a technique that often is capable of dislodging the stuck item. Anyone can do it.
Face the back of the person, place your arms under his arms and around the chest. Lock your hands together in the position of a fist and place them between the naval and the rib cage. Suddenly squeeze the arms and thrust the fist forcefully into the abdomen in order to create a rush of air from the lungs into the trachea (wind pipe). This quite frequently forces out the bolus of food or pill and allows breathing to resume.
Small children can be held upside down by the feet, and patted on the back in the attempt to dislodge what is caught in the throat.
While this is being done, someone else should be calling the emergency number 911 for a doctor, ambulance, or fire department.
If the obstruction has not been dislodged a tracheotomy or vertical slit in the trachea must be made to allow the ingress of air necessary to save the person’s life.
Recently a young boy was featured on the evening TV news because he saved his sister’s life when something became stuck in her throat and he performed the Heimlich Maneuver. He had seen it demonstrated just a few days before and fortunately remembered what he had to do.