Tablets and capsules that stick in the oesophagus

Many patients complain that tablets or capsules stick in the gullet. Actual hold-up in the oesophagus is also common but often unnoticed. In one study, 98 patients each swallowed 2 aspirin-sized tablets containing contrast medium with 15 ml of water and then lay down. 1 X-rays showed that the tablets stayed in the oesophagus for more than 5 minutes in over half the patients, but only two with an oesophageal stricture were aware of the delay. Damage is uncommon but can occur, often without symptoms at first, when an irritant medication is held up in the oesophagus; oesophagitis develops which may progress to oesophageal ulceration and even stricture. The presenting symptoms are dysphagia and pain, usually retrosternal and often severe. Deaths have occurred from perforation or haemorrhage. 2 3