Ask Dr. Richard Liebowitz: When a Pill Gets Stuck

Q: What should I do if I am taking medication and the pills get stuck? This has happened to me several times. I'm not choking and can still talk, but I can feel the pill moving in my throat when I swallow.

— Hazel, Canada

A:  Pills can get stuck when swallowed and cause significant problems through mechanisms that are not entirely understood. Some compounds, including medications that treat osteoporosis (Fosamax [alendronate], for example) are very irritating to the esophagus, and people taking these drugs are always instructed to sit upright for at least 30 minutes after taking the dose. This is because the medication can cause a problem known as esophagitis — inflammation of the esophagus that can lead to serious complications, including pain and bleeding. This problem requires two factors: a pill or capsule getting lodged in the esophagus, leading to a prolonged period of contact, and a compound that is either too acidic or basic for the esophagus. Other medications that can cause direct irritation to the esophagus include anti-inflammatory agents such as ibuprofen, tetracycline antibiotics, iron, and potassium.
To avoid the problem of pills getting stuck, prevention is clearly key. Follow these steps:

• Never take a medication when you are lying down; instead, sit or stand when swallowing a pill.
• Remain upright for at least 30 minutes afterward if possible.
• Drink enough liquid — usually a minimum of eight ounces — when taking pills so that the pill is “chased” down.

If you feel the sensation of a pill being stuck, drinking fluids and eating small amounts of food such as bread may be helpful, if the medication can be taken with food. Call your doctor if the feeling persists despite these steps or if you feel pain. Treatment may include localized measures to decrease the inflammation, pills to decrease acid production if reflux is believed to be worsening the symptoms, or an upper GI endoscopy in rare cases.
Learn more in the Everyday Health Healthy Living Center.