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Why do I get so congested after I eat?
June 26, 2013 2:32 PM   Subscribe

I'm trying to figure out why I get congested after I eat many types of foods. Often after I finish a meal, I get very congested in my chest 10-15 minutes later, and my throat and chest feel somewhat tight. Not wheezing-I-can't-breathe tight, but tight like how things feel during a panic attack. When this happens I have to cough a lot and clear my throat to get the phlegm out of my chest. Then, after about 15-20 minutes, everything goes away and I feel normal. What's going on?

This has been happening for years, but seems to be getting more frequent as of late. It does not happen after all meals - I've noticed that it happens mostly with Asian food of all types, Indian food, Mexican food, and anything that involves spicy. However, it's also happened after eating smoked salmon, cured meats, and a salad that contained only vegetables and dressing. Really the only time it does not happen is when I prepare bland foods from fresh ingredients at home. It sucks because the aforementioned types of foods - the ones that make this happen - are my favorites!

I consulted an allergist because I thought maybe I am allergic to peppers or chiles or something, but he said my symptoms are not really indicative of a food allergy (no wheezing, swelling, hives, etc.) and that it is more likely a sensitivity to something, which apparently you can't really test for. Since this happens so much it is more annoying now than scary, but it is uncomfortable (feeling your chest and throat tighten up is never fun) and it has made me not really look forward to meals out.

What should I do? Should I go on a total detox/cleanse for a few weeks and then slowly reintroduce certain foods? Should I see another doctor? Should I start keeping a food diary?

Also, has anyone dealt with anything similar?
posted by emily37 to Health & Fitness (31 answers total) 7 users marked this as a favorite
 
Is it possible you have acid reflux?
posted by thewumpusisdead at 2:37 PM on June 26, 2013 [2 favorites]


Acid reflux symptoms can be very varied and confusing, and the triggers can be varied. Both my husband and I suffer from reflux of some severity, but our symptoms are entirely different. For me, it is a hot, burning pain in my sternum, almost like what I imagine a heart attack feels like. For him, it becomes difficult to swallow - no pain, but a very tight feeling in his throat.

I would try over the counter preventatives like prilosec or something. If those work, you can talk to a doctor about a daily prescription (my husband takes aciphex) if this is something that happens every day, or you can keep taking the OTC preventatives before meals.

My reflux is, so far, mild enough that I just avoid triggering foods - for me, it's beer and super-gluteny foods (wheat pasta is generally OK, barley isn't).
posted by muddgirl at 2:39 PM on June 26, 2013


yeah, sounds like reflux.
posted by dawkins_7 at 2:41 PM on June 26, 2013


That's an interesting theory! I never thought about acid reflux because I never have any of the symptoms that I associate with that (heartburn, sternum pain, sour stomach, etc.) I'm not really a big fan of the idea of having to go on a daily prescription, though. Maybe I should try to find the main offenders food-wise and try to cut down on them?
posted by emily37 at 2:44 PM on June 26, 2013


Exactly this happens to me.

It is cold-induced asthma, typically the result of drinking beverages with a lot of ice in them, or eating cold foods like ice cream. I thought it was a food allergy for a long, long time, but no, it's a temperature thing. I didn't figure it out until I was in my 30s.
posted by Andrhia at 2:50 PM on June 26, 2013


It doesn't sound likely, but...

if you are going to a doctor and having a blood test, please ask them to test for celiac disease. It is a relatively simple blood test and it would be very good to have this eliminated. Also, if you detox/cleanse and avoid gluten your celiac blood test could/will turn up negative. Don't ask the doctor to test for celiac if you have been avoiding gluten.
posted by jazh at 2:51 PM on June 26, 2013


Google coughs after eating, seems to be fairly common. I didn't find a definite answer but..
posted by Ferrari328 at 2:53 PM on June 26, 2013


Long shot, but you may be approaching hypertension, could be the salt quantity in the food.

Seems like a panic attack because your blood pressure is rising due to the salt.

IANAD but I KNOW this feeling and that's what causes it for me.
posted by Max Power at 2:57 PM on June 26, 2013


I agree that you should talk to your doctor and rule out scarier things like celiac.

I eliminated trigger foods but if my husband tried to do that, he wouldn't be able to eat basically any grains at all. Both his doctor and my doctor recommended trying food elimination first. There are other options for acid reflux somewhere in between the two, like a targeted preventative ("I want to have spicy food today, so I'll take a pill.")
posted by muddgirl at 3:06 PM on June 26, 2013


I have always called this the Cheesy Chogies, since it seems to happen more after eating something with cheese in it.
posted by annsunny at 3:07 PM on June 26, 2013


Could it be a histamine response?
Foods that trigger a histamine response include:
~ mackerel, herring, sardines and tuna;
~ fermented, aged and processed meats and cheeses;
~ Sauerkraut, pickles, olives and other vegetables that are pickled or preserved;
~ other fruits/veggies like tomatoes, eggplant, pumpkin, avocado, mushroom and spinach;
~ alcoholic drinks including wine, beer and champagne; and
~ foods that have artificial colors and preservatives. [source]
posted by parilous at 3:08 PM on June 26, 2013 [2 favorites]


parilous - might as well throw myself off a bridge if I can't eat the things on that list :)
posted by emily37 at 3:08 PM on June 26, 2013 [1 favorite]


Odd question to those who suspect acid reflux. Why would acid in the stomach or lower esophagus lead to phlegm? Phlegm is produced by the respiratory and not digestive system.

I think there is something else going on here.
posted by Leenie at 3:21 PM on June 26, 2013


Note that I'm not a doctor and can't actually diagnose acid reflux. Reflux can cause coughing - the phlegm may be coincidentally present (such as a combination of seasonal allergies and reflux). A general practicioner may have a wider range of medical theories than an allergist.
posted by muddgirl at 3:25 PM on June 26, 2013


I suspected I was sensitive to gluten for other reasons and did an elimination diet. When I reintroduced gluten, I was really surprised to realize that it made me feel congested about 20 minutes later. So definitely try an elimination diet!

I have also had acid reflux (after eating gluten) that felt like constriction/tightness in my chest/throat.

Might be a good idea to talk to a GI doc.
posted by lunasol at 3:32 PM on June 26, 2013


Odd question to those who suspect acid reflux. Why would acid in the stomach or lower esophagus lead to phlegm? Phlegm is produced by the respiratory and not digestive system.

Because acid reflux can cause post nasal drip, which makes you cough like a mofo.

This happens to me with Indian and Mexican food, too. In fact, I realized it was happening when I worked next to a Mexican restaurant. About once a week, I would eat a burrito and drink a beer and come back to the office coughing and all stuffed up. There are a host of things you can try: tums, zantac, or a medicine like prilosec, which you take for about three weeks every few months.

You really should get this addressed, though, because GERD can lead to other problems, from cavities to esophageal cancer.
posted by PhoBWanKenobi at 4:03 PM on June 26, 2013 [1 favorite]


See another allergist. The fact that it's getting worse worries me. My dairy allergy went from similar mild symptoms to full blown hives and serious asthma. Now I have to carry epipens everywhere.

I bet it is reflux but the breathing trouble is worrying.
posted by the young rope-rider at 4:03 PM on June 26, 2013 [1 favorite]


I don't think reflux caused post nasal drip can happen that quickly.

I would be more likely to suspect a histamine response, a sodium response, a tyramine response, an MSG response, or a spiking blood sugar response.
posted by gjc at 4:20 PM on June 26, 2013 [1 favorite]


What finally got me to a doctor about my reflex what outright choking, particularly on food. BUt that tight, can't clear my through feeling was also part of it. It was GERD bad enough to require an upper endoscopy.
posted by COD at 4:30 PM on June 26, 2013 [1 favorite]


I had these exact same symptoms for years; acid reflux was the cause. It can show up as a variety of things, including asthma like breathing difficulty/chest tightness and (and PhoBiWanKenobi linked) congestion and sinusitis. GERD is a many splendored thing.

Fortunately, there are a bunch of simple fixes for GERD: watching closely how you react to certain foods and avoiding the worst, any number of antacid/proton pump inhibitors (most available without prescription), and a bunch of natural fixes (the most touted on the internet being apple cider vinegar and magnesium supplements). If none of these work for you and your GERD continues to get worse there's a low risk surgical fix; however, because there's so many other interventions, no guarantee insurance will cover it.
posted by givennamesurname at 4:33 PM on June 26, 2013


When I had a similar sort of phlegmy cough after drinking hot beverages or eating spicy foods, it was because I was getting over a cold and it went away after a couple of weeks. Since you've been dealing with this for years though, I think GERD is a likelier culprit, though I've never heard of getting a tight feeling in your chest from it.
posted by yasaman at 4:44 PM on June 26, 2013


My vote is for reflux.

There's an easy way to test it. Go buy a two-week supply of Prilosec (generic is fine) at the drugstore and take it every day, whether you think you need it or not (it has a cumulative effect). If your symptoms lessen, it's reflux. If not, it's not. This is basically the first step your doctor will take anyway, and Prilosec isn't going to hurt you or make you sick if you don't need it.

I have GERD and I almost never had heartburn. In fact, it got diagnosed because the acid was breaking down my teeth. (This is a very expensive incentive to get this investigated, by the way.) I also felt a tightness of chest and a sensation that my throat was swelling closed.
posted by elizeh at 5:59 PM on June 26, 2013 [2 favorites]


See a different allergist or an ENT. I've never had good luck with allergists. Get them to test you for basic food allergies. Your symptoms could be a result of a combination of factors. For instance, when there's a high pollen count and I eat dairy, I produce lots of phlegm, have chest tightness and shortness of breath, and cough a lot. It's because I have severe pollen allergies, a mild dairy allergy, and asthma. Some things are complicated. You need a smarter doc. Good luck!
posted by dovesandstones at 6:13 PM on June 26, 2013


Regarding histamine response, I've had some success supplementing with SAMe. It helps you break down the histamine you make so that crazy overload isn't so likely to happen. Still, good to know what the triggers are.
posted by Rube R. Nekker at 6:15 PM on June 26, 2013


Thank you everyone. I think I am going to try the reflux test that elizeh suggested, and go on omeprazole for 14 days to see if that helps. If not, I'll try a new allergist :)
posted by emily37 at 6:16 PM on June 26, 2013


I'd really suggest talking at least to a GP. They can tell you whether a reflux med is a good idea or if you should speed to an allergist. Even if it's not, you might need to get an endoscopy or be tested for H. pylori.

We don't know enough about your medical history, symptoms, etc. to really give you a diagnosis or a medication regimen that can actually rule anything out (or in). I don't think there's anything wrong with trying an over the counter reflux med but if it is a food allergy, they can get dangerous really quickly with little warning and I would hate for you to be unprepared for that.

Good luck, I hope you feel better soon!
posted by the young rope-rider at 6:36 PM on June 26, 2013


sulfites?
posted by egk at 7:24 PM on June 26, 2013


Another vote for sulphites, it gives me an asthma type reaction that is kind of confusing when you don't understand the source. I get reactions to all kinds of things, and it's gotten worse as I've gotten older. Sulphites are all over the place in processed foods, particularly with coconut or salad dressings. Coincidentally, I have found myself more sensitive since developing reflux. If you drink (any liquid!) with your meals, I'd stop that... and well, figure out your triggers! Once I identified mine, life became a lot easier.
posted by sunshinesky at 7:56 PM on June 26, 2013


Everyone talking about reflux is talking about GERD, or gastroesophageal reflux disease, but what it sounds more like to me is LPRD, or laryngopharyngeal reflux disease, a.k.a. "silent reflux." That's the kind that can cause anything from major postnasal drip and/or a "cold" feeling in one's upper esophagus and back of the throat to chronic sore throats, phlegm, and coughing to even acid spurting back up into the back of one's mouth. Basically, the acid goes up a lot higher in the esophagus, even up to the nose, and there's a whole range of potential symptoms, such that a lot of people don't even suspect they have it. If the reflux meds help, you could have that just as easily as you could have GERD.
posted by limeonaire at 8:12 PM on June 26, 2013


I get something similar when I drink Coke. Also Indian food. I do have GERD, but I don't think it's that. I just think those foods bring up stuff that was already in my lungs.
posted by professor plum with a rope at 11:57 PM on June 26, 2013


Is it really so likely to be wrong that nobody else has suggested it, to consider an anti-histamine reaction to MSG? Since it doesn't happen when you cook food from scratch, much more likely to be a widely-used commercial additive.
posted by glasseyes at 9:02 AM on June 27, 2013


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