Ask Dr. Kent . . .

I notice after I have a meal, I always start coughing, usually producing phlegm. Why would that happen? I do not experience any pain.

Anytime someone comes into my office complaining of coughing with meals, the first concern I have is that of a swallowing problem. Some people cough with meals due to some of the food going the wrong way into the lungs and can increase the chances of developing aspiration pneumonia. Sometimes, coughing with eating can be caused by a problem with the esophagus. It may not be contracting in an organized fashion to get food transported into the stomach. Sometimes, people have problems with reflux, getting foods and stomach acid into the lungs. This can cause lung irritation.

I have had patients with esophageal strictures or growths in the esophagus causing problems with swallowing. Other times, coughing after eating could be due to food allergies. A gastroenterologist can perform a procedure called an EGD (esophagoduodenoscopy.) This is a fiber optic camera placed down the throat into the stomach to look for any strictures, masses, or irritation of the stomach or esophagus.

There are swallowing studies that can be ordered to check the normal peristaltic activity of the esophagus, the tube running from the mouth to the stomach.

A speech therapist is helpful when performing a swallowing study. They can determine how well a patient chews their food and can determine the consistency of foods best tolerated by patients. Thickened liquids are sometimes swallowed more successfully.

Food allergy testing can be done by skin prick testing or from blood serum allergy testing. In any case, you should see your primary care physician to evaluate and treat your problem.