DEAR DR. BLONZ: I take several prescription pills and supplements every day. I have no difficulty swallowing them without any water or other liquid. I have read that one should always use some water when taking pills, but is there any harm in not doing so? -- R.M., San Ramon, California
DEAR R.M.: Questions about prescribed medicines should be discussed with the health professionals doing the prescribing, and you can speak with your pharmacist when you pick up your meds. Because complete information is essential for your care, those making decisions about treatments involving your health should know everything you take -- including dietary supplements. Be upfront about any "fad" diets, including intermittent fasting and ketogenic eating, which can impact health conditions and how the body handles medications. (More on food-medicine interactions at b.link/n7vfspfg.)
There is concern as to whether medications and dietary supplements should be taken simultaneously. The human body will treat certain compounds as foreign substances. Usually handled by the liver, there are metabolic pathways to deactivate and eliminate them. Multiple substances relying on the same pathway can impact the process, which explains why certain medications should not be taken together. Certain foods can react with or prevent the absorption of medications in the GI tract. (Find online drug interaction checkers at b.link/jhjpw348 and b.link/quwac8.)
Multi-pill swallowing without water may have worked for you, but it poses unnecessary risks. Any distraction during the act of swallowing -- such as a sudden noise -- can increase the dangers. The biggest risk is a pill getting stuck in the throat or inadvertently inhaled into the lungs. A pill lodged in the throat can irritate and damage tissue and cause heartburn and chest pain (pill-induced esophagitis); certain medications and supplements present the most danger. It is even more serious if a pill gets inhaled, as this can cause choking/aspiration, coughing, pain and tissue damage -- even leading to pneumonia. (Check the article on aspiration at b.link/j8s5qlqf.)
Understand that the substances you are taking are concentrates that rely on body fluids to dissolve and allow their contents to pass through the intestinal wall before becoming part of your water-based systems. Without water to surround them on their way in and down the throat, pills can get lodged, or end up where they don't belong. Use care so that any pills prescribed for your treatment do not end up harming you.
You asked about taking many pills at the same time. Some patients have difficulty taking even one! Such readers should check out these tips for swallowing pills at b.link/i75xdabz.
Send questions to: "On Nutrition," Ed Blonz, c/o Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO, 64106. Send email inquiries to questions@blonz.com. Due to the volume of mail, personal replies cannot be provided.