Differential Diagnosis for Cough when Eating Candy

• Single most likely diagnosis
  • Irritation of the larynx or pharynx due to candy triggering a cough reflex: This is likely due to the physical properties of the candy (e.g., size, shape, texture) causing mechanical irritation or the sweetness/sourness of the candy stimulating the nerves in the throat.
• Other Likely diagnoses
  • Asthma or chronic obstructive pulmonary disease (COPD) exacerbation: Certain ingredients in candy, such as sulfites or artificial flavorings, can trigger asthma or COPD symptoms, including coughing.
  • Gastroesophageal reflux disease (GERD): Eating candy, especially those with high sugar or acid content, can trigger GERD symptoms, including coughing due to stomach acid reflux into the esophagus.
  • Allergic reaction: Some individuals may be allergic to specific ingredients in candy, leading to an allergic reaction that includes coughing as a symptom.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Aspiration: Choking on candy can lead to aspiration, which is a life-threatening condition that requires immediate medical attention.
  • Foreign body obstruction: Lodging of candy in the airway can cause a foreign body obstruction, which is a medical emergency.
  • Anaphylaxis: A severe allergic reaction to an ingredient in the candy can cause anaphylaxis, a potentially life-threatening condition that requires immediate treatment.
• Rare diagnoses
  • Eosinophilic esophagitis: A rare condition characterized by inflammation of the esophagus due to an allergic reaction or other causes, which can be triggered by eating certain foods, including candy.
  • Cough variant asthma: A type of asthma that presents primarily with a chronic cough, which can be triggered by various factors, including eating certain foods or substances.