Most of us at some point have taken a pill without water, either because we were in a rush, too lazy to get up from our desk, or there wasn’t a drink nearby. But here’s why it’s actually quite dangerous—even fatal.
Washing a pill down with water is important not only because it makes swallowing easier, but because it helps prevent the pill from getting stuck in your esophagus, which can cause much more than discomfort. “Medications that are lodged in the esophagus are very likely to cause inflammation and irritation,” says Jennifer Caudle, DO, a board-certified family medicine physician and assistant professor in the department of Family Medicine at Rowan University-School of Osteopathic Medicine. “This can cause a number of symptoms from heartburn and chest pain to esophagitis, or even bleeding and holes.”
Since there are no pain nerves in parts of the esophagus, symptoms don’t always begin right away, which can make it difficult for you to know if a pill doesn’t make it all the way down. Some people experience chest pain or a feeling similar to heartburn, so they might just dismiss the sensation as a temporary discomfort. Over time, however, pills that get stuck along their journey can break down and erode the delicate tissue of the esophagus, causing painful bleeding and hemorrhaging, or severe dehydration, all of which can become quite serious.
A study from the Turkish Journal of Gastroenterology found that almost any kind of drug can cause an ulcer in the esophagus, but according to Dr. Caudle, a few common medications can cause significant damage when they get stuck, including drugs to treat osteoporosis, antibiotics, and over-the-counter pain relievers. “Pain relieving medications such as Motrin and Advil are commonly taken without water, and that class of drugs can be notoriously problematic if they get lodged in the throat,” says Caudle. A surgeon at Morristown Memorial Hospital in New Jersey tells the story of a teenage football player who would pop two Advil with no water before every game—and developed an esophagus that looked “like Swiss cheese” for all the holes the pills had burned. Vitamin C and iron supplements have also been found to be especially problematic.
To avoid dangerous complications when swallowing pills, it’s always best to wash them down with at least eight ounces of water, Caudle advises. She also recommends taking pills standing or sitting up, never lying down. This means you should avoid taking medication right before bed, or at least 15 minutes before bed, to allow the pill time to travel down the esophagus.
“It’s not to say that if you don’t drink anything, your pill will always get stuck,” says Caudle. “But the risk is higher if you don’t have a full glass of water.” Don’t miss the other over-the-counter medication mistakes you’re probably making.