How do patients with dysphagia take their medication?

  ”The most direct response is to drink more soup and water so that the food that is “stuck” in the esophagus can be pushed into the stomach. In the daily diet, dry rice (solid food) can be changed to thin rice (semi-liquid food), or easy-to-eat types such as milk or nutritional drinks (liquid food) to facilitate eating. For patients with dysphagia or their caregivers, how to take medication correctly and safely? There are also some points that should be clarified and noted.  If something goes wrong in the process, it will cause “dysphagia,” especially for elderly people who like to play wind instruments or those who have esophageal cancer, it may lead to diseases such as esophageal diverticulum or pharyngeal bulge, which will affect the delivery of food.  For those who feel “dysphagia”, it is recommended to consult a doctor to confirm the cause. Motor and mechanical disorders are the two main causes of dysphagia. The former refers to abnormalities in the muscles or nerves that govern the swallowing steps, and the swallowing muscles are unable to deliver properly or the nerves are dysfunctional, which is common in diseases such as post-stroke dysphagia and Parkinson’s disease. The latter is more common due to narrowing of the esophageal cavity, which may be caused by diseases such as esophageal tumors and ulcerative crusting of esophagitis, resulting in reduction of the diameter of the esophagus.  It is best to sit upright (about 90 degrees) or stand up, or for those who are bedridden, swing up the head of the bed or use a pillow to support the upper body.  Please inform your physician or pharmacist, and read the instructions for use such as the medication bag or the medication manual. For those who are taking drugs that are large in size and cannot be mixed in half or powdered (such as sustained release, extended release, enteric coated, etc.), or who need to eat through a nasogastric tube, please inform your physician or pharmacist and choose a drug that can be powdered or prepared as a liquid (e.g., “Acme Foam”, which reduces the mucous membrane secretion of the respiratory tract, can be placed in a drinking water container, dissolved with a small amount of water, mixed well, and then consumed directly. For example, “Nesion”, an anti-gastric ulcer drug, contains enteric granules, which can be soaked in water before taking, and then immediately poured in after disintegration; “Prozac”, a drug for treating severe depression and peripheral neuralgia in diabetes, can be soaked in water after opening the capsule and then immediately poured in, etc.). Or orally dissolved lozenges (e.g. “Teck Gastrodon orally dissolved lozenges” for anti-gastric ulcer; “Lululemon D sustained release orally dissolved lozenges” for urological use; “Zimprosol orally dissolved lozenges” and “Metropin orally dissolved lozenges” for neuropsychiatric use, etc.) or other feasible alternative methods. If it is easy to choke on the powder, you can add a little water first; if you have difficulty in drinking water, you can mix Nestle coagulation powder to increase the stickiness and make the medicine thicker before feeding.  Concentrate when taking medicine. Concentrate on taking the medicine and drinking the water; don’t talk while the medicine is in your mouth to avoid distractions as much as possible.  Take an adequate amount of water. Many medications are inherently acidic and alkaline, and not drinking enough water while taking medication may burn the throat or esophagus, so it is generally recommended to drink about 200 to 250 ml. In 2014, scientists at the University of Heidelberg in Germany studied the best way to swallow ingots and capsules, and based on the difference in density between the two, they suggested the following: place the medication on the back of the tongue, and in the case of ingots, drink the water bottle in the mouth, tilt the head and swallow in one go; in the case of capsules, drink a sip of water, tilt the head slightly forward and swallow when swallowing.  If your condition allows, you can try sucking on popsicles, ice chips or lemon cubes, or drink lemon-flavored water to increase saliva secretion and to activate the swallowing frequency.  Finally, take your medication slowly and without haste, just like eating. If you need to take more than one medication at the same time, you need to pay attention to the amount of each bite, not more than 1/2 teaspoon (about 2.5 ml), and make sure you swallow it completely before taking the next bite.