The influence of size, specific gravity, and head position on the swallowing of solid preparations

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Abstract
Aim: To clarify the influence of size and specific gravity of solid preparations, and the position of healthy volunteers when swallowing, for the purpose of practical use in patient consultation regarding the taking of medicines.Materials and methods: The paper reports three studies. Volunteers were asked to swallow four different capsules (A, large and heavy; B, large and light; C, small and heavy; D, small and light) in Study 1, two preparations with different positions (upright, horizontal, and chin‐down) in Study 2, and two preparations before and after anesthetization of the bilateral lingual and inferior alveolar nerve in Study 3. The oral transit time (OTT) and pharyngeal transit time (PTT) were evaluated with videofluoroscopy.Results: The mean OTT became longer in the order of C, D, B, A. The mean PTT showed no statistically significant differences. The swallowing preference of the four preparations ranked by the subjects showed that difference in size but not the difference in specific gravity is a significant factor. In the chin‐down position, OTT was shorter for two preparations, compared with the other two positions. The mean OTT for both the A and B preparations was significantly longer after the bilateral lingual and inferior alveolar nerves were anesthetized.Conclusion: When swallowing solid preparations, a consideration of size and the position will enable ease of swallowing of medicines. This would especially be the case when delivery of the medicines to be taken by the aged suffering from oral hypoesthesia caused by an underlying disease.

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