Influence of the Swallowing Posture and Liquid Thickness on the Ease of Pill Swallowing in Healthy Adults

Lee, Won Kyung; Seo, Han Gil; Cha, Seung Woo; Yeom, Jiwoon; Lee, Woo Hyung; Oh, Byung Mo; Han, Tai Ryoon

Abstract

OBJECTIVE
To investigate the influence of the swallowing posture and liquid thickness on the easiness of pill swallowing in healthy adults. METHOD: The subjects were 12 healthy young group (19-40 years) and 10 elderly group (65- years). Each subject was examined under videofluoroscopy while swallowing barium-containing placebo pills with six different methods: free fluid with neutral (FN), chin down (FD), chin up (FU), head rotated to left (FL), head rotated to right postures (FR), and thickened fluid with neutral posture (TN). The subjects rated their ease of pill swallowing on a 5-point Likert scale. Time variables were evaluated from the videofluoroscopy images. RESULT: FD, FU and FL were rated significantly less comfortable than FN for pill swallowing. Duration from the start signal to the mandible angle and to laryngeal elevation was significantly prolonged with FD and FL compared to FN. Duration from the start signal to the upper esophageal sphincter was significantly prolonged with FD compared to FN. There were no significant differences on either easiness of swallowing or the time variables between FN and TN. Duration from the start signal to the mandible angle and to the upper esophageal sphincter was significantly longer in the elderly group than the young group with all swallowing methods except FU. In the elderly group, duration from the start signal to laryngeal elevation was significantly shorter with FU than FN.
CONCLUSION
Chin down posture is uncomfortable and prolong swallowing time during pill swallowing. In the neutral posture, pill swallowing with thickened fluid is comparable to that with free fluid. Chin up posture may shorten pill swallowing time in elderly.