Coughing when you drink or eat is an involuntary reflex that protects your airway from foreign substances. This reflex is triggered when liquid or food accidentally “goes down the wrong pipe” and gets into your windpipe (trachea) instead of your esophagus. When this happens, receptors in your trachea detect the irritation and send signals to your brain stem, which then initiates a cough to forcefully expel the material and prevent it from reaching your lungs.
What causes coughing when drinking?
There are a few common reasons why liquid may end up in your windpipe and trigger coughing when you drink:
- Swallowing too quickly – Drinking too fast can cause liquid to flow down your trachea before your epiglottis (a flap that closes off your windpipe during swallowing) has time to close.
- Uncoordinated swallowing – Some neurological or muscular conditions affect the coordination of swallowing, making it more likely for liquid to go down the wrong way.
- Problems with the epiglottis – Damage or weakness of the epiglottis can prevent it from properly closing off the trachea during swallowing.
- Respiratory infections – Swelling and mucus production from infections like bronchitis or pneumonia can interfere with the glottis closure.
- Medical conditions – Diseases like stroke, Parkinson’s disease, multiple sclerosis and ALS can impair control of swallowing.
- Anatomical abnormalities – Physical deformities of the throat or esophagus may direct liquid into the trachea.
- Reduced gag reflex – Aging or certain medications can decrease the gag reflex, making it less likely for a person to cough up or spit out misdirected liquid.
- Alcohol consumption – Drinking alcohol can impair reflexes needed for coordinated swallowing and decrease sensations in the throat.
In most cases, coughing from drinking is just an occasional accident that happens when you swallow too quickly or aren’t paying attention. But if it becomes a frequent occurrence, it could indicate an underlying medical issue.
What happens when liquid goes down the wrong pipe?
Here is what takes place when you accidentally inhale liquid into your windpipe instead of swallowing it properly:
- The liquid comes in contact with sensitive nerve endings that line your trachea and bronchi (large airways).
- These nerve endings send signals to the brain stem reflex center, which controls automatic protective responses.
- The brain stem reflex center activates your cough receptors and diaphragm.
- Your glottis briefly closes off your airway and your diaphragm forcefully contracts.
- The high pressure generated forces open your glottis and expels the irritating material and mucus out through your mouth.
- Rapid coughs continue until your airway is cleared of the irritant.
- Once the irritant is expelled, the cough reflex stops.
This cough reflex plays a vital role in keeping unwanted material from entering your lungs. Without it, pneumonia and other infections would be much more common.
Why do some drinks make me cough more than others?
Certain beverages tend to trigger coughing when drank incorrectly more often than others. Some reasons particular drinks lead to more coughing include:
- Carbonation – Fizzy drinks like soda and beer release bursts of air bubbles that can irritate your throat and make you cough if they go down your windpipe.
- Alcohol content – Alcohol can numb sensation in your throat and impair the swallowing coordination needed to direct liquid properly.
- Hot temperature – Very hot drinks like coffee can burn and irritate your throat, making coughing more likely if swallowed improperly.
- Thick consistency – Drinks like smoothies or slushies are thicker and more likely to coat and irritate your trachea.
- Citrus juices – The acidity of juices like orange, grapefruit or lemon can provoke coughing if they enter your windpipe.
You can reduce coughing from specific drinks by taking smaller sips, waiting for fizz to settle in carbonated beverages and allowing very hot drinks to cool slightly before drinking. Drinking through a straw can also help bypass your throat and direct liquid farther back into your mouth.
When should I worry about coughing while drinking?
Occasional coughing after drinking or eating is normal and not a cause for concern. However, you should contact your doctor if you experience any of the following:
- Frequent episodes of coughing or choking while eating and drinking
- Coughing that lasts several minutes and leaves you short of breath
- Hoarse, gurgly sounding cough after swallowing
- Coughing up blood tinged mucus
- Difficulty controlling liquids and food in your mouth
- Increased coughing episodes at night
- Weight loss or fever along with swallowing problems
- Coughing from drinks that didn’t cause issues previously
These signs may indicate an underlying condition, such as:
- Problems with your esophagus muscles or lower esophageal sphincter
- Esophageal strictures or rings of scar tissue
- Neurological disorders affecting swallow coordination
- Stroke or damage to the nerves involved in swallowing
- Lung disease such as pneumonia, COPD or pulmonary fibrosis
- Laryngeal cancer or cancer of the throat
Early evaluation for persistent coughing or choking while drinking allows proper treatment to prevent complications likeaspiration pneumonia, malnutrition and choking injuries.
How is chronic cough when drinking evaluated?
If you regularly cough when drinking or have difficulty swallowing, your doctor will likely recommend some of the following tests to identify the cause:
- Modified barium swallow study – You swallow barium coated liquid and food while X-rays track the motion to identify swallowing issues.
- Endoscopy – A lighted tube with a camera is passed down your throat to examine your esophagus, stomach andupper intestines.
- Manometry – Pressure sensors measure contractions and muscle coordination in your esophagus during swallowing.
- pH monitoring – A probe measures acid levels in your esophagus to check for reflux.
- Laryngoscopy – A scope examines your larynx and vocal cords to check for lesions, inflammation or impaired motion.
Based on exam findings and test results, your doctor can determine if you have a structural obstruction, problems with nerves and muscles, reflux disease, or other conditions leading to your swallowing difficulties and cough.
How can I prevent coughing while drinking?
You can reduce instances of coughing or choking while drinking by:
- Avoiding gulping your drinks or tilting your head back as you swallow
- Taking small sips and swallowing completely before taking another drink
- Keeping your chin tucked as you swallow
- Staying upright for at least 30 minutes after eating or drinking
- Eating slowly and chewing solid foods thoroughly before swallowing
- Taking liquids with meals instead of alone
- Using a straw to direct liquids towards your back teeth
- Treating heartburn or gastroesophageal reflux disease if present
- Doing swallowing exercises if you have muscle weakness
- Not talking, laughing or physically exerting yourself when you have food or liquid in your mouth
Making a conscious effort to drink slowly, pay attention while swallowing and avoid distractions can go a long way towards preventing accidental coughing or choking episodes.
What helps stop coughing after choking on a drink?
If you start uncontrollably coughing after accidentally inhaling liquid down your windpipe, some remedies to help stop coughing include:
- Remain upright and lean forward to allow gravity to help clear your airway.
- Forcefully cough out the irritant a few times by taking deep breaths and contracting your abdomen.
- Sip small amounts of warm water to soothe your throat and thin out mucus.
- Suck on lozenges or gargle salt water to coat and numb your throat.
- Take anti-inflammatory medication like ibuprofen to reduce swelling.
- Use a humidifier to loosen thick mucus and make coughs more productive.
- Avoid touching the back of the throat to prevent gagging or vomiting.
- Rest your voice and avoid whispering or clearing your throat.
If coughing persists longer than a few minutes or you see blood or difficulty breathing, seek emergency care to ensure your airway is clear and there is no fluid in your lungs.
How do doctors treat chronic coughing when swallowing?
Treatment for chronic coughing, choking or aspiration when swallowing depends on the underlying cause but may include:
- Diet modifications – Your doctor may recommend thickening liquids, avoiding mixed consistency foods or sticking to soft, moist foods.
- Swallowing therapy – Specific exercises can strengthen throat muscles involved in swallowing.
- Medications – Drugs that reduce acid, decrease inflammation, or improve muscle coordination may be prescribed.
- Surgery – Procedures to widen the esophagus, remove obstructions or tighten the lower esophageal sphincter may be done.
- Feeding tube – If swallowing is very impaired, a gastric tube may be placed to provide nutrition.
A speech pathologist will typically work closely with your doctor to teach safer swallowing techniques and design a tailored dysphagia therapy plan for your situation.
What complications can arise from chronic coughing when swallowing?
Left untreated, chronic coughing or choking episodes when eating and drinking can lead to serious secondary health issues such as:
- Chronic pneumonia due to aspiration of food and liquids into the lungs
- Malnutrition and weight loss from eating less to avoid coughing
- Dehydration due to insufficient fluid intake out of fear of choking
- Increased risk of choking injury or death
- Respiratory failure
- Damage to the lungs due to recurrent infections
- Electrolyte imbalances
That’s why it’s critical to consult your doctor if you regularly experience coughing or choking when swallowing food or drink. Proper diagnosis and management can prevent the risk of these complications.
When to see a doctor
You should make an appointment with your doctor if you experience:
- Frequent coughing or choking when eating and drinking
- Coughing that disrupts your ability to swallow
- Weight loss due to difficulty eating and drinking
- Coughing up blood
- Increased choking episodes
- Hoarseness, gurgling or wheezing when swallowing
Evaluation by a gastroenterologist or otolaryngologist (ENT doctor) can help diagnose the source of your swallowing problems. Early treatment improves outcomes and prevents complications.
Conclusion
Coughing when you swallow liquids or foods is usually just a temporary annoyance caused by accidentally inhaling down the wrong pipe. But persistent or worsening coughing with swallowing difficulties warrants medical assessment for underlying conditions. With proper diagnosis and management, complications can often be avoided.
Careful swallowing techniques, close attention while eating and drinking, and prompt evaluation of ongoing choking or coughing episodes are key to prevent serious consequences and enjoy drinks safely.