When food or drink unexpectedly comes out of your nose during a meal, it’s called nasal regurgitation. This happens when the swallowing process is briefly disrupted. Understanding how we swallow explains why this occurs.
Understanding the Swallowing Process
Swallowing is a complex, coordinated process that moves food from your mouth to your stomach. It begins with chewing and forming food into a soft mass, called a bolus, which is then moved to the back of the mouth. An involuntary reflex takes over as the bolus reaches the back of the throat, initiating the pharyngeal phase.
During this phase, the soft palate, at the back of your mouth, elevates to seal off the nasal cavity, preventing food and liquids from entering the nose. Simultaneously, the voice box (larynx) lifts, and the epiglottis, a leaf-shaped cartilage, folds down to cover the windpipe (trachea), safeguarding the airway. These actions redirect food into the esophagus, the muscular tube that transports it to the stomach through wave-like contractions.
Reasons Food Goes Up the Nose
Nasal regurgitation happens when the soft palate fails to close off the nasopharynx, the upper part of the throat connected to the nose, during swallowing. This allows food or liquid to backtrack into the nasal passages. Common scenarios can temporarily disrupt this protective mechanism.
Sudden actions like laughing, talking while eating, or sneezing can interfere with the muscle coordination required for swallowing. For instance, a sudden laugh can cause momentary relaxation or incomplete elevation of the soft palate, creating an opening for food to enter the nasal cavity. Attempting to talk while food is in the pharynx can disrupt the synchronized movements of the soft palate and other structures, leading to accidental redirection of the bolus. Swallowing too quickly can also overwhelm the system, making it difficult for the soft palate to close in time.
When to Consult a Doctor
While an occasional instance of food coming out of the nose, particularly due to laughing or talking, is not a concern, frequent occurrences warrant medical attention. If this symptom occurs regularly, or with liquids in addition to solids, it could indicate an underlying swallowing disorder, known as dysphagia.
Other symptoms warranting a doctor’s visit include persistent coughing or choking during or after eating, a sensation of food sticking in the throat or chest, or voice changes like a gurgly sound after swallowing. Difficulty swallowing with pain, drooling, unexplained weight loss, or recurrent chest infections (like pneumonia) are also red flags. These signs could point to issues with swallowing muscles or nerves, or structural abnormalities. A healthcare professional can determine the cause and recommend management.