A Cough After Eating

An occasional cough after eating is common, and you will likely be fine. Despite how annoying it is, cough is an essential reflex of our body to expel irritants, germs, mucus and foreign substances from our respiratory system.1 Furthermore, an absent or abnormal cough reflex can be dangerous.¹ However, you can’t help but wonder, should you be worried or get yourself checked? Thus, this article will explore the possible cause and treatments for a cough after eating.  

Coughing fits or chronic coughing?

Cough can come in different faces and variations, such as coughing fits and chronic coughing.

Coughing fits also called pertussis or commonly known as whopping cough, is a contagious disease caused by a type of bacteria called Bordetella pertussis.² 

It spreads from one person to another by coughing or sneezing.² It can also be spread when you share breathing space with a person with coughing fits. An infected person can be contagious for up to 2 weeks. 

On the other hand, chronic cough in an adult is commonly caused by asthma, upper airway cough syndrome, and gastroesophageal reflux disease.3 Patients with chronic coughing should avoid exposure to cough-evoking irritants.³ In an adult, chronic cough can last up to 8 weeks.³ However, children's coughing for more than four weeks is already classified as chronic.³

What are the possible causes of a cough after eating?

Acid reflux

Symptoms and treatment

Acid reflux occurs when stomach acid travels up towards your throat. 4 The main symptoms of acid reflux include:⁴

1. A burning feeling in the chest or heartburn
2. Weird sour taste in your mouth due to stomach acid
3. Persistent cough
4. A hoarse voice
5. Bad breath
6. Feeling unwell and bloating

These symptoms might get worse after eating. The treatment for acid reflux is to change your lifestyle such as trying to lose weight if you are overweight, quitting smoking and reducing your alcohol consumption.⁴

GERD (Gastroesophageal reflux disease)

Symptoms and treatment

GERD, or its full name, gastroesophageal reflux disease is a chronic form of acid reflux where your gastric content comes up to your oesophagus. Symptoms of GERD are:⁵

1. Heartburn
2. Regurgitation 
3. Chest pain
4. Dental erosions
5. Chronic cough
6. Laryngitis
7. Asthma

Treatments option for GERD include:^5,6 

1. Lifestyle modification
2. Medical therapy
3. Surgical therapy
4. Endoluminal therapy

Laryngopharyngeal reflux (LPR)

Symptoms and treatment

According to Cleveland Clinic, laryngopharyngeal reflux is a condition in which stomach acid travels up to your oesophagus and affects your vocal chord or glossitis.⁷ Acid in the oesophagus can cause chronic cough and lead to LPR.⁷ But, what are the differences between GERD and LPR? Patients with GERD have an abnormality in their lower oesophagal sphincter. In contrast, patients with LPR have dysfunction of their upper oesophagal sphincter.⁷

Common symptoms of LPR are:⁷ 

1. Hoarseness
2. Globus sensation
3. Throat clearing
4. Postnasal drip or throat mucus
5. Coughing after eating or lying down
6. Chronic cough
7. Breathing difficulties

However, there are less common symptoms of LPR: heartburn and regurgitation.⁷

Just like GERD and acid reflux, modifying your lifestyle is an effective treatment to treat your LPR. This includes:⁷ 

1. Weight loss
2. Reducing your meal size
3. Refrain yourself from lying down within 3 hours of a meal
4. Consuming low fat and acid diet
5. Avoiding carbonated or caffeinated beverages
6. Quit smoking
7. Reducing alcohol consumption

If lifestyle modification doesn’t help, medications such as histamine-2 receptor antagonists and proton pump inhibitors might help you to suppress acid production. Surgical therapy (Nissen fundoplication) can be used to decrease symptoms.⁷

Asthma

Symptoms and treatment

If you tend to cough after eating, asthma might be the possible cause. Asthma is a chronic disease that causes inflammation and narrowing of the airways. It usually presents in childhood and is commonly associated with other illnesses such as hay fever and eczema.⁸

Symptoms of asthma include:⁸ 

1. Shortness of breath
2. Cough
3. Wheezing

Some of the treatments options for asthma are:

1. Medical management
2. Weight loss, quitting smoking, changing your occupation(if possible) and self-monitoring your symptoms

Food allergies

Symptoms and treatment

A food allergy is when your body has an unusual response to proteins in the food which will cause an allergic reaction.⁹ 

There are various symptoms of food allergy are:⁹

1. Skin
2. Eczema
3. Acute urticaria and angioedema, which are often linked with egg, milk, peanuts, nuts, sesame and poppy seeds, kiwi
4. Perioral dermatitis
5. Gastrointestinal tract
6. Irritability, vomiting, diarrhoea or poor weight gain
7. Respiratory tract
8. Wheezing and cough 

Treatment for food allergy is usually epinephrine and antihistamines. Patients with food allergies should be trained to recognize the initial symptoms and use epinephrine.⁹

RTI (Respiratory tract infections)

Symptoms and treatment

Another common cause of coughing after eating is upper respiratory tract infections (URTI).¹⁰ Acute cough is usually associated with URTI, which is maintained by various viruses and bacteria.^10,11 URTI involves your nose, sinuses, pharynx, larynx and large airways.¹⁰ Example of URTI is the common cold and influenza.¹⁰

Symptoms of URTIs usually include:¹⁰

1. Cough
2. Sore throat
3. Runny rose
4. Headache
5. Sneezing 

Treatments for URTI include early antiviral treatments (to shorten the duration of influenza symptoms) and vaccination (to prevent influenza illness).10 On the other hand, decongestant and combination antihistamines/decongestant medication can suppress cough and other signs of the common cold in adults.¹⁰

Dysphagia

Symptoms and treatment

Dysphagia is a medical term for difficulties in swallowing, commonly present in the elderly.¹² Common related symptoms of dysphagia are:¹² 

1. Choking and coughing
2. Eating more slowly
3. Throat clearing before and after eating
4. A feeling that food stuck in the mid-chest or throat
5. Weight loss

A speech therapist can help people with dysphagia to manage their eating habits, including techniques to swallow food properly.¹²

Treatments for dysphagia depend on the individuals and whether the patients have other conditions.¹⁰ For example, in people with advanced Parkinson's disease, dopamine precursor L-DOPA treatment will not work on them.¹²

Aspiration pneumonia

Symptoms and treatment

Aspiration pneumonia is when food and fluid accidentally enter your lungs.¹³ Common symptoms of aspiration pneumonia include:¹⁴ 

1. Cough
2. Choking
3. Short of breath
4. Speaking difficulty
5. Hoarseness
6. Cyanosis
7. Tachypnea
8. Tachycardia 

Closely monitoring the patient’s oxygen saturation is essential for the treatment. Some patients will be given antibiotics to slow down the process of disease. If the patients have a penicillin allergy, the doctor might provide clindamycin.¹⁴

When to see a doctor

An occasional cough is likely to be alright. However, if it happens regularly, getting help from your doctor might be a wise decision, especially when:

1. Your cough has been persistent for three weeks
2. You feel unwell
3. Your cough is getting worst
4. You’re losing weight
5. You have difficulty in breathing
6. You have a weak immune system

Preventing a cough after eating

Several tips to prevent a cough after eating may include:

1. Eat a much smaller amount of food and make sure to chew carefully
2. Avoid allergic triggers
3. Do not lie down after meals.

Summary

Coughing after eating might be annoying, but it is common. However, it could be due to other medical conditions reviewed in this article. Thus, if you feel like your cough is not normal, seek help from your healthcare provider immediately. Your doctor can give you treatment or medications that suits you. At the same time, you can follow the tips suggested in the article to prevent a cough after eating.