Differential Diagnosis for Cough after Drinking or Eating and Throat Clearing

• Single most likely diagnosis
  • Gastroesophageal reflux disease (GERD): This condition is characterized by the backflow of stomach acid into the esophagus, which can irritate the throat and trigger coughing, especially after eating or drinking. The symptoms of GERD, such as heartburn and regurgitation, often accompany the cough.
• Other Likely diagnoses
  • Laryngopharyngeal reflux (LPR): Similar to GERD, LPR involves the backflow of stomach acid, but it reaches the laryngopharynx, causing irritation and symptoms like chronic cough, throat clearing, and hoarseness.
  • Postnasal drip: This condition, often due to allergies or a cold, can cause a sensation of mucus running down the back of the throat, leading to frequent throat clearing and coughing.
  • Asthma: Although more commonly associated with wheezing and shortness of breath, asthma can also present with a chronic cough, which may be triggered by eating or drinking due to the inhalation of particles or the stimulation of airway receptors.
• Do Not Miss diagnoses
  • Aspiration pneumonia: This is a serious condition that occurs when food, liquids, or other materials are inhaled into the lungs, potentially leading to infection. It's crucial to consider this diagnosis, especially in patients with neurological disorders or those who have difficulty swallowing.
  • Esophageal obstruction or stricture: Conditions that physically block the esophagus can cause food and liquids to be regurgitated, leading to coughing and throat clearing. These conditions require prompt medical attention.
  • Lung cancer: Although less common, lung cancer can cause a chronic cough, among other symptoms. It's essential to consider this diagnosis, particularly in patients with a history of smoking or other risk factors.
• Rare diagnoses
  • Eosinophilic esophagitis: An inflammatory condition of the esophagus that can cause difficulty swallowing, food impaction, and potentially coughing due to the irritation of the esophagus.
  • Foreign body aspiration: Although more common in children, adults can also accidentally inhale objects, which can cause sudden onset of coughing and other respiratory symptoms.
  • Achalasia: A rare disorder of the esophagus that makes swallowing difficult, leading to regurgitation of food and potentially coughing.