Experts say most people should have no trouble swallowing pills as even the bigger ones are no larger than a chewed mass of food. GERALDINE LING reports

Bitter pills are not the only ones that are hard to swallow. The bigger ones may seem daunting too.

However, Ms Tang Li Jin, a compounding pharmacist at Customized Health Solutions Compounding Pharmacy,  has some reassuring advice.
 
She said that if a person has no difficulty swallowing food normally, he should be able to swallow pills as even the bigger ones are typically no larger than a chewed mass of food. A compounding pharmacist customises medicine according to a patient's needs, like changing the form of a medication from a solid pill to a liquid if he has swallowing difficulties.

Swallowing problems may, in fact, be caused by medical problems like, say, tumours.

She said that people who have problems swallowing food should talk to their doctor before they pop pills of any size.

For the rest of us who just find pills hard to swallow, here are five tips:

1 Take a deep breath before putting the pill in your mouth. Ms Tang said that this may help to suppress gag reflexes.

2 When swallowing, place the pill on the back of your tongue, drink some water, tilt your chin down towards your chest and swallow. Tilting the chin suppresses the gag reflexes and opens up the passage for swallowing, she said.

However, do not place the pill too far back on your tongue. Dr Goh Shu Huey, a partner and family physician at Frontier Healthcare Group, said this may trigger gag reflexes.

3 Place the pill on the tip of your tongue, drink some water, then tilt your head back and swallow.

Ms Tang said that this method may be more suitable for those who find pills bitter as the taste buds that identify bitterness are located at the back of the tongue.

Tilting the head back gently allows the water and pill to slide down the throat. However, over-tilting may cause choking, she cautioned.

4 Do not crush or cut pills before swallowing. Dr Goh said that this may affect how the pills dissolve in the stomach.

For example, the timed-release variety gradually releases the drug into the body. Crushing such pills may cause a faster release of its contents in the stomach, she explained.

However, she said that some pills like antacids are meant to be chewed before swallowing. Therefore, crushing such pills is acceptable.

5 Taking pills with soft food like pudding and yogurt may help.

The food’s thicker consistency helps to push the pills down. Also, their sweetness may mask any bitter taste, said Dr Goh.

Certain medications, however, lose their effectiveness if mixed with certain foods or liquids, she said, citing the example of alendronate, a drug used to treat osteoporosis. Food affects its absorption.

Ms Tang pointed out that some medications are meant to be taken on an empty stomach. Taking them together with food may affect absorption too.

When in doubt, consult your doctor or pharmacist.