Description and Possible Medical Problems

We’ve all had a piece of food go down the “wrong pipe.” Fortunately, for most of us, this kind of episode stops just short of requiring the Heimlich maneuver. While it may cause a temporary sore throat and loss of appetite, it’s not a serious problem.

For people who are frail and elderly, however, it’s another story. In fact, it’s not uncommon for them to cough while they’re eating or drinking. This especially tends to happen if a family member is feeding them, as the role reversal tends to make both parent and child tense.

In the elderly, the swallowing mechanism can become progressively weaker due to chronic illness, a stroke, or advanced dementia as caused by Alzheimer’s disease. As a result, food can very easily go down into the windpipe, or trachea, which can potentially be very dangerous. Small amounts of food in the trachea can cause a lung infection called aspiration that can lead to aspiration pneumonia, a condition that can be lethal in a person whose immune system is already weakened by age and disease. Aspiration pneumonia requires hospitalization with intravenous antibiotics.

If an elderly relative often coughs while he’s eating, his family should consult with his physician, who may contact an ear, nose, and throat specialist and/or even a speech language pathologist with expertise in swallowing disorders. Either of these specialists may perform special “dysphasia evaluations,” which check a person’s ability to swallow various types of food. These specialists may then recommend dietary adjustments (such as pureeing certain foods) to relieve the difficulties in swallowing.


If your elderly relative has developed aspiration pneumonia, hospitalization is necessary. This will include a complete course of intravenous antibiotics. If feeding becomes a consistent problem despite treatment, it may become necessary to insert a feeding tube into the patient’s stomach for a short time to make sure he gets the nutrition he needs.


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