Coughing After Eating: Causes and Treatments

Coughing is an important reflex that helps clear substances from your air passages. In fact, coughing during meals could save your life in an emergency. However, frequently coughing after eating (medically known as a postprandial cough) can be disruptive, frustrating, and even a sign of a more serious health condition.

While coughing after eating is common, there are many reasons why you might experience it. These underlying reasons may cause your cough to be acute (short-term) or chronic (long-term).

Acute coughing often stems from a single event like inhaling food or drinks into the windpipe—or, having something “go down the wrong pipe.” Chronic coughing often happens due to acid reflux or asthma. That said, getting a proper diagnosis can help you treat symptoms appropriately.

Symptoms of postprandial cough can vary, often based on the underlying cause that’s causing your coughing. If you cough after meals, your cough may be wet or dry.

Wet coughs can stem from inhaling a liquid or increased mucus production in the back of the throat. Dry coughs may occur due to an irritant in the throat such as dust or very dry air. Depending on the cause, post-meal coughing can be a sudden, strong cough for a short time or a lingering mild cough.

There are many potential causes of coughing after eating. You might cough after a meal simply because you inhaled a sip of your drink while talking. You might live with an underlying health condition that causes irritation or increased mucus in your throat.

If you have symptoms, seeking care from your healthcare provider can help you understand the exact cause of your coughing and get the treatment you need to find relief.

Aspiration

Aspiration is the medical term for having something go down the wrong pipe. This is when you inhale food, drinks, or even saliva into your windpipe (known as the trachea) instead of pushing it into your food pipe (known as the esophagus). Coughing is a natural reflex that helps your body push the substance back out of your windpipe before it can get into your lungs. 

Most people aspirate accidentally now and then. People with dysphagia (a swallowing disorder) tend to aspirate more frequently. Dysphagia has several possible causes, but they all result in trouble moving food from the mouth into the esophagus. Older people are more likely than other groups to have this condition.

You may be at an increased risk of frequent aspiration if you:

Acid Reflux

Acid reflux occurs when stomach acid flows backward into the esophagus. This is medically known as gastroesophageal reflux (GER). Acid reflux can happen to anyone once in a while. But when GER is severe or chronic, it can develop into gastroesophageal reflux disease (GERD). An estimated 20% of people in the United States live with GERD. A similar condition known as laryngopharyngeal reflux (LPR) occurs when acid backs up into the esophagus and voice box.

Both GERD and LPR commonly cause chronic coughing, especially after eating. This may be partially because the backward-flowing acid irritates the lining of the esophagus. Coughing also may happen due to other symptoms of GERD and LPR, including:

• Regurgitation (stomach contents flowing back into the throat)
• Increased mucus production
• A feeling that something is stuck in your throat
• Burning sensation in your throat
• Trouble breathing

Allergies

Allergies are a major cause of chronic cough, which can happen after eating and any other time of day. An allergy develops when your body’s immune system mistakes a harmless substance for a dangerous one and tries to fight it off. This is called an allergic reaction. People can develop allergies to foods or things that exist in the environment.

Common food allergens include eggs, dairy, nuts, shellfish, and wheat. Common environmental allergens are tree pollen, pet dander, and mold. 

Just as allergens can vary widely, symptoms of an allergic reaction can vary between people. Coughing after meals may be one symptom, but other symptoms may include trouble breathing or hives on your skin.

Asthma

People with asthma experience inflammation, swelling, and tightness in their airways. Coughing is one of the most common symptoms of asthma, along with wheezing and shortness of breath. In fact, coughing is the only symptom for some people with a type of asthma called cough-variant asthma.

Asthma can trigger coughing after eating for the following reasons:

• Increased mucus production
• Food additives
• Inhaling irritants or allergens
• Laughing while eating

Postnasal Drip

Postnasal drip refers to the sensation that you might feel when mucus builds up in the back of your throat. While everyone produces mucus in their throats, some conditions can increase the amount of mucus you have and cause you to cough to clear the mucus up. You might develop postnatal drip for the following reasons:

• Viral infections like the common cold or influenza (flu)
• Sinus infections
• Allergies, especially to foods like dairy
• Exposure to cold or dry air
• Medications that increase mucus production

Everyone coughs after eating once in a while, and coughing is usually not a cause for concern. However, if you notice that you consistently cough after meals, visit your healthcare provider for a diagnosis. Knowing what is causing the coughing can help you avoid serious complications.

Your primary care provider may refer you to an ear, nose, and throat specialist (ENT). These providers can diagnose the cause of postprandial cough by performing several tests to understand why you’re experiencing symptoms. These tests might include:

• Laryngoscopy: Uses a flexible or rigid scope with a light and a camera attached (endoscope) to visualize your larynx and vocal cords for inflammation, swelling, or structural abnormalities (e.g., polyps)
• Upper endoscopy (EGD): Using an endoscope with a light and a camera attached to look inside your nose or throat (e.g., if GERD is the suspected cause)
• Esophageal pH test: Measures how often stomach acid enters your esophagus (the tube from your throat to your stomach) and how long it stays there

Spirometry, lung function tests, or allergy tests might be used if the suspected cause is allergies or asthma.

Other imaging scans like X-rays or computed tomography (CT) scans might check for signs of inflammation or injury. The modified barium swallow test is a special type of X-ray that allows your healthcare provider to see how well you swallow. These tests might be used if the provider is concerned about aspiration (inhaled substances entering your lungs).

When your primary care provider and ENT learn the underlying cause of your coughing, they can help you develop a treatment plan to offer symptom relief.

The goal of treatment for postprandial cough is to reduce your symptoms. Depending on the cause of your coughing, treatment options may include:

• Dietary changes: If you consistently aspirate liquids, eating only thick foods can help you avoid coughing. If food allergies or asthma are causing your symptoms, avoiding foods that trigger coughing can be helpful. But if acid reflux is the culprit, limiting acidic, spicy, and fatty foods, as well as caffeine and alcohol can offer relief.
• Medications: Antacids, H2 blockers, and proton-pump inhibitors can help manage the symptoms of GERD and LPR. Anti-inflammatory medications or bronchodilators (inhalers) can help open up your airways if you have asthma. Over-the-counter antihistamines can also help manage symptoms if you have food or environmental allergies.

If your coughs after eating a meal are bothersome, there are some ways to limit your coughing episodes. Consider these prevention strategies:

• Eat slowly
• Try not to talk while you eat
• Do not eat while lying down
• Lie down two to three hours after completing a meal
• Drink water to thin out the mucus in your throat
• Treat underlying health conditions (such as GERD or asthma)
• Take recommended over-the-counter (OTC) medications for acid reflux and environmental allergies

Each cause of coughing after eating has its own possible complications, including:

• Aspiration: If coughing doesn’t help your food or drinks go into the correct pipe, inhaled substances will enter the lungs. This brings bacteria into the lungs, which can lead to aspiration pneumonia, which is a medical emergency. Choking is another and more common compilation of aspirating food.
• GERD: Acid reflux often leads to heartburn (acid indigestion)—a burning or painful sensation in the chest. Over time, GERD can lead to tooth enamel decay and a hoarse voice. In serious cases, GERD can lead to inflammation, constriction, sores, and bleeding in the esophagus.
• Allergies: An extreme allergic response can cause anaphylaxis. This is a life-threatening body-wide response that needs emergency medical attention. If you suddenly have trouble breathing, confusion, light-headedness, or heartbeat changes after eating, call 911 or visit the emergency department as soon as possible.

Postprandial coughing, or coughing after meals, can have many causes ranging from food entering the wrong pipe or living with underlying health conditions like asthma.

You can limit and manage how often you’re coughing after meals with remedies such as medications and dietary changes. Because chronic coughing after eating can sometimes lead to serious complications, early diagnosis and treatment are key.