Coughing until throwing up is a distressing, yet common, bodily reaction to various underlying conditions. Understanding its mechanisms and causes can help individuals navigate this uncomfortable situation.
Understanding the Cough-Vomit Reflex
The human body has protective reflexes, with coughing being a primary one, clearing irritants and mucus from the airways. Forceful or prolonged coughing can trigger vomiting due to the close proximity and shared neural pathways of involved systems.
The gag reflex, a protective contraction of the pharynx (throat), is a significant factor. Intense coughing spasms stimulate this reflex, initiating vomiting. Forceful coughing also increases intra-abdominal pressure, which, combined with strong abdominal muscle and diaphragm contractions, contributes to expelling stomach contents.
The vagus nerve, a cranial nerve, plays a role in both the cough and vomiting reflexes. Extending from the brainstem to organs like the lungs and digestive tract, its stimulation during severe coughing can link these functions, explaining the connection.
Underlying Conditions Causing Vomiting After Coughing
Numerous medical conditions can lead to coughing severe enough to induce vomiting. Identifying the cause is important for effective management. These conditions range from common infections to chronic respiratory and digestive issues.
Common Respiratory Infections
Acute respiratory infections are common causes of cough-induced vomiting. Acute bronchitis, often following a cold or flu, inflames bronchial tubes, leading to a persistent cough that can be dry or produce mucus. This forceful coughing can trigger gagging and vomiting.
Pneumonia, an infection inflaming lung air sacs, causes a cough with discolored mucus, leading to nausea and vomiting. Whooping cough (pertussis) is a bacterial infection with severe, uncontrollable coughing fits that often culminate in vomiting and can make breathing difficult. Respiratory syncytial virus (RSV) can also cause inflammation and increased mucus production, leading to severe coughing that might induce vomiting, particularly in infants.
Postnasal Drip
Postnasal drip occurs when excess mucus drains down the back of the throat, irritating it and triggering coughing. This irritation can be enough to activate the gag reflex and lead to vomiting. Swallowed mucus can also upset the stomach, causing nausea and vomiting.
Asthma and Allergies
Asthma involves inflammation and narrowing of airways, leading to coughing, wheezing, and increased mucus. These symptoms can be severe enough to cause vomiting, especially during flare-ups or after exposure to triggers like allergens or cold air. Cough variant asthma, a specific type, presents solely as a chronic, dry cough forceful enough to trigger vomiting without other typical asthma symptoms. Allergies can also cause chronic coughing due to airway irritation or increased postnasal drip, potentially leading to vomiting.
Gastroesophageal Reflux Disease (GERD)
Gastroesophageal Reflux Disease (GERD) is a condition where stomach acid flows back into the esophagus, irritating its lining, throat, and airways. This irritation can cause a chronic cough, often worse at night or after meals. The reflux-triggered cough can become severe enough to cause vomiting. This creates a cycle where reflux causes coughing, and coughing can exacerbate reflux, potentially leading to vomiting.
Chronic Bronchitis
Chronic bronchitis, often seen in smokers, involves persistent inflammation of the bronchial tubes. This condition leads to a daily, persistent cough that produces mucus. The ongoing, productive cough can be intense enough to result in gagging and vomiting.
Medication Side Effects
Certain medications can cause a chronic cough as a side effect, potentially leading to vomiting. Angiotensin-converting enzyme (ACE) inhibitors, for high blood pressure and heart conditions, are known for this. The cough associated with ACE inhibitors is typically dry and persistent, likely due to chemical accumulation in airways. While not dangerous, this cough can be bothersome and severe enough to cause vomiting.
When to Seek Medical Attention
While occasional cough-induced vomiting may not indicate a serious problem, certain signs warrant medical evaluation. Persistent symptoms, especially if they don’t improve within a few weeks, warrant a healthcare professional visit.
Seek immediate medical attention if vomiting is severe or prolonged, or accompanied by other concerning symptoms. These include coughing up blood or blood-tinged mucus, signaling a more serious issue. Difficulty breathing, chest pain, or a high fever also require urgent medical care. Unexplained weight loss, changes in energy levels, or bluish discoloration of the lips, face, or fingertips also indicate a need for medical consultation. This information serves as a guide and does not replace professional medical advice.