Why am I coughing?
September 11, 2023 2:52 PM   Subscribe

YANMD. Why do I get a tickle in my throat causing an immediate need to cough, and I'm nearly choking on the trigger foods? This has only been happening in the last week or so and only with "dry, crumbly foods". Sweet potato chips, French fries, corn dog, bread. If the food is wet, it doesn't happen. So when I had some sourdough bread mixed into a French onion soup, it was fine.

As far as I've known, I don't have food allergies. I'm pretty sure I've developed asthma, though, and it's gotten to the point where i need a diagnosis. In the last week, ive had coughing fits that dont calm down. I have an abuterol inhaler my doctor prescribed 6 months ago, but she never did any asthma testing. I have been using it like multiple times a day when I've had these coughing fits.

I'm going to ask my GP to test me for asthma and allergies next week.

But I really need to advocate for myself and understand what's going on.

I've read different articles about coughing after eating. And none of the causes explain exactly what's happening. Maybe it's a slight case of GERD or acid reflux? Or maybe this is just asthma.

Still, just looking online I can't find anything about dry foods causing coughing. Except where you've inhaled it in your lungs. I mean, I don't think that's what's happening?

I'm just confused and my healthcare sucks. I'm switching next May when I can but in the meantime I want to see if anyone has had a similar experience and what was causing it?

Today I haven't had a problem so far but I'm trying to avoid any dry foods.

I'm sick with something. Tested negative for covid self-pcr at my clinic, at home tested twice. So I had something that turned into these coughing fits. It's getting better but I'm just curious what is going on!
posted by AnyUsernameWillDo to Health & Fitness (15 answers total)
 
It sounds to me as though your throat is just particularly dry at the moment, and when you go to swallow dry foods it's causing an irritation that moist foods, or foods taken with liquids don't cause.
Try to avoid dry swallowing for a reasonable time and see if the irritation goes away.
It doesn't sound like you've got difficulty breathing, which lowers my alarms (NYD), you're throat just doesn't like foods drying it any further and is reacting by making you cough.
posted by OHenryPacey at 3:17 PM on September 11, 2023 [1 favorite]


Any chance you've got a burgeoning tonsil stone the dry things are catching on/rubbing against?
posted by phunniemee at 3:23 PM on September 11, 2023 [3 favorites]


Sorry you're going through this.

Could be a dry mouth/dry throat issue, from any number of things, and the crumbly food texture is just a sticking point. Unfortunately, the frequent inhaler use could be making it worse? (You were prescribed the albuterol inhaler without asthma testing; you've been using it multiple times a day for this dry-cough issue; it's possible to use an inhaler improperly if it's new to you, or to have a paradoxical response to inhalers even if you have asthma. And inhalers can make your mouth dry.)

Try taking small sips of water all day. Use sugar-free lozenges. Get enough liquids with your meals.
posted by Iris Gambol at 3:24 PM on September 11, 2023 [1 favorite]


I'm an emergency physician.

If you feel like food is stuck in your throat, but you're not choking and you feel the need to cough, the most common culprit is Gastroesophageal Reflux Disease (GERD).

GERD is a more serious version of acid reflux. Both cause heartburn--the diff btw the two being frequency. Heartburn more than twice a week = GERD, which, pathophysiologically, results from the closure in your lower esophagus—which is near your stomach—becoming weak or relaxing when it shouldn't.

Try sipping plenty of water between bites of food, and take an over-the-counter antacid like Tums 10-15 minutes before eating

Or maybe this is just asthma.

No.
posted by BadgerDoctor at 3:40 PM on September 11, 2023 [11 favorites]


On review, should have pointed out that fullness in the throat can occur in addition to heartburn or independent of it altogether. I don't have the statistics in front of me, but I'm pretty sure the 2nd most common symptom of GERD is the feeling of sth being stuck in the throat
posted by BadgerDoctor at 3:52 PM on September 11, 2023 [4 favorites]


IANAD, but I do have both GERD and asthma. Maybe try taking Tums or prilosec? GERD can irritate your throat and make swallowing more difficult - i need to drink a lot of water with any drier foods to get them down.

Is the albuterol actually helping? Did your doctor show you how to use it (or did you at least carefully read through the instructions)? I found albuterol often really irritated my throat. I eventually developed a paradoxical reaction to it (verified with lung function tests)

Do you have any other asthma symptoms? Chest tightness, shortness of breath, wheezing?

I've had some pretty severe coughing fits triggered by acid reflux.

It's really hard for me to imagine how dry foods could possibly trigger asthmatic coughing, unless you literally inhale those foods.

Since it sounds like your GP is not a good resource (just handing you an albuterol inhaler with zero asthma testing seems...not great), you can order a "peak flow meter" from amazon or similar. Try taking your peak flow at the same couple of time points each day (first thing in the morning, middle of the day, right before bed). Record the peak flow. Do that until your appointment. Also try taking your peak flow directly before and after you use the albuterol inhaler (if you decide to use the albuterol inhaler again). Obviously doesn't replace competent medical care, but it could give you something to show to your doctor, if nothing else.
posted by litera scripta manet at 5:07 PM on September 11, 2023 [1 favorite]


some blood pressure medication or tricyclic anti-depressants can cause this..
posted by evilmonk at 5:26 PM on September 11, 2023 [2 favorites]


I have a related problem caused with nerve damage to my throat. My airway perceives everything a threat. and coughs at a huge list of triggers, including the foods you list.

I'm not saying this to scare you, but mine has been part of a bigger issue that's had me coughing for 9 years. In my case, the nerve damage probably started with a pertussis infection. It's unlikely that's your problem, of course. But mostly i want to report that coughs can often be nerve issues in the throat rather than respiratory conditions or pulmonary problems.
posted by mermaidcafe at 6:51 PM on September 11, 2023 [2 favorites]


Meant to add tips.

Can you practice diverting your cough? When you feel one coming on, take a drink of water or swallow or hum instead.

It's possible you had a problem with a trigger food that your body is remembering. If you eat small bites with plenty of water, does that help? Can you avoid trigger foods for a little while?

IANYD, but sometimes I've had to use a chloraseptic throat numbing spray before, which has helped with my cough.
posted by mermaidcafe at 6:54 PM on September 11, 2023 [2 favorites]


This sometimes happens to me when I have sinus drainage. I have GERD, so my throat is often a little tender anyway. Add sinus drainage causing more irritation, and swallowing large mouthfuls or anything can trigger a tickle that turns quickly into a coughing fit

So when I'm sick I take half bites of wetter foods, or take a sip of liquid right before I swallow drier stuff.
posted by Vigilant at 9:22 PM on September 11, 2023 [1 favorite]


To add to the quasi-scientific possibilities, you may be triggering an esophageal spasm (which can be triggered itself by GERD). I have a similar issue in that I get the urge to couch (at its mildest), hiccups (moderate), to sustained painful esophageal spasm (worst) when I eat foods that have some textural traits in common. Usually, it's starchy or crunchy foods that have a lot of air in them or are very aerated by chewing before swallowing. Bread and apples are two main offenders, but it's been known to happen with french fries and even crudites like raw carrots. This sounds really, really similar to your foods list.

What helps me is to eat slowly, and taking small bites so that I'm swallowing small volumes instead of large, air-filled bolus (which seems to be an almost guaranteed trigger). As others have suggested, making the bolus wetter before you swallow can help occupy some of those air spaces and reduce the risk that this textural thing is a contributing cause.

Esophageal spasm is no joke, When it hits, I can feels the spasm traveling upward in my throat in slow waves. My mouth overproduces saliva that I can't swallow, so I basically sit over a sink and try to keep spitting rather than trying to swallow (which is PAINFUL and can make the spasm worse). One doctor recommended I hyperventilate myself to trigger an end to the spasm, which sometimes seems to help but it's not the most pleasant thing to do. Hang in there!

BTW you'll see a lot of people online have googled "hiccups after bread?" and the like, so we're not alone here!
posted by late afternoon dreaming hotel at 2:20 AM on September 12, 2023 [1 favorite]


Best answer: If you started blood pressure medication about six weeks ago some people have a reaction that causes a cough. Lisinopril is the one that did it for me.

- https://pubmed.ncbi.nlm.nih.gov/8862965/
- https://www.verywellhealth.com/lisinopril-causes-cough-1124151
- https://www.startpage.com/do/dsearch?query=ace+inhibitor+cough
posted by Awfki at 5:00 AM on September 12, 2023 [4 favorites]


I am not a doctor but I do run an allergy and asthma support group.

Regardless of your GP's interpretation of your asthma test results, I recommend you ask your GP to give you a referral to see either an allergist or a pulmonologist about the asthma symptoms. Your GP is not a specialist in respiratory illnesses, and asthma is a serious medical condition that merits specialist care. Hopefully your GP will already know this and direct you to see a specialist anyway, but if they don't, ask!

The medical term for the difficulty swallowing you are experiencing is dysphagia. There are a few different conditions that can cause it. GERD, as already mentioned, is one of them, but so is eosinophilic esophagitis (EoE), an allergic condition in which certain foods or environmental allergens trigger an inflammatory reaction in the esophagus that can cause the esophagus to constrict. The only way to sort out for certain which of multiple conditions might be causing your swallowing problems is to see a gastroenterologist for evaluation.

Asthma does not generally speaking cause people to have difficulty swallowing food. BUT people with asthma are statistically more likely (for reasons still unknown) to develop GERD, and the two conditions can exacerbate one another-- asthma triggered coughing fits can cause more stomach acid to wind up in the wrong places, and acid from GERD can enter the airway and trigger asthma attacks. So people who are not receiving appropriate treatment for both conditions can get into sort of a cyclical situation where both of these conditions are aggravating the other.

People with asthma are also more likely to develop EoE than the general population, because both conditions fall under the broad "allergy" umbrella and are signs of a chronically overachieving immune system. In fact there is a specific type of asthma, eosinophilic asthma, that is triggered in a similar way to EoE specifically by the overproduction of eosinophil immune cells in response to exposure to allergens or irritants.

Difficulty swallowing is a symptom that should not be ignored, even if it isn't preventing you from eating because you've found ways to eat around it (like sticking with softer foods). Conditions that cause dysphagia can damage your esophagus over time and it's important to prevent serious long term damage by seeking treatment, which could involve medications, diet changes, or both.
posted by BlueJae at 9:09 AM on September 12, 2023 [1 favorite]


I have been coughing on and off due to GERD for better part of two decades. But it is definitely a lot worse when I am more stressed.

In addition, I found myself with quite bad sinus discharge earlier this year and that triggered coughing fits like nothing I've experienced. The mucus was much more persistent in the back of my throat than the acid. Using a neti pot was very helpful.

I can absolutely see something like a higher than normal level of mucus reinforcing the feeling of crumbs at the back of your throat while also making them slower to pass.
posted by koahiatamadl at 10:07 AM on September 12, 2023 [2 favorites]


Response by poster: Thanks everyone. I think it's my medication, lisinopril, since it only started after that. And it was a risk factor they told me about. 😬 made an appt with my doctor to tell her and ask for a different med.
posted by AnyUsernameWillDo at 6:51 PM on September 16, 2023 [1 favorite]


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