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Entry of Food and Liquids in The Airways Symptoms & Causes

Food and liquids entering the airways can be dangerous—find out how this happens and ways to get relief.
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Last updated February 9, 2021

Airways questionnaire

Use our free symptom checker to find out what's causing your airways.

Airways questionnaire

Use our free symptom checker to find out what's causing your airways.

Airways symptom checker

Entry of food and liquids in the airways symptoms

Aspiration means the inhalation, or breathing in, food, liquid, or anything else such as gastric contents. The substance(s) may only go as far as the airway (trachea or windpipe), or it may go all the way into one or both lungs. This will stimulate an immediate, involuntary reaction of violent coughing as the body attempts to get the foreign substance out of the sensitive airways. Aspiration is not choking.

Characteristics of Aspiration

Aspiration can be acute or chronic, which are described below, as well as silent. Silent aspiration means there are few or no symptoms except for recurrent pneumonia. This is most common in people with a prior stroke or dementia.

Acute aspiration

Acute aspiration means the sudden inhalation of food, drink or gastric (stomach) contents. It may involve:

Chronic aspiration

Chronic aspiration means small amounts of food or drink find their way into the lungs over time due to constant difficulty swallowing. It may involve:

  • Recurrent cases of pneumonia
  • Milder coughing or wheezing after eating
  • Feeling that food is caught in the throat after eating
  • Constantly clearing the throat during and after eating
  • Voice changes: A voice that sounds "wet," gurgling, or congested
  • Chronic, unexplained fevers: Especially right after eating

Other characteristics

Other characteristics and symptoms that may arise with aspiration include:

  • Dehydration: The person may avoid drinking liquids due to fear of aspirating.
  • Malnutrition and unexplained weight loss: The person may avoid eating as much as possible due to fear of aspirating.

Who is most often affected by aspiration?

People who are most likely to experience aspiration include:

When are aspiration symptoms most likely to occur?

Aspiration is likely when eating or drinking and:

  • Doing so too quickly
  • Being distracted, upset, or nervous
  • While under the influence: Of alcohol, illicit drugs, or medication

Are aspiration symptoms serious?

The severity of aspiration can vary.

  • Not serious: Occasional, brief coughing while eating or drinking is very common and is not serious.
  • Moderately serious: If any foreign substance gets into the lungs and stays there — even though the person is no longer in distress — it can cause inflammation, infection, and long-term damage to the lung tissue that must be treated by a medical provider.
  • Serious: If there is enough liquid in the lungs, the person can develop significant breathing problems if not treated immediately. If a piece of food or other solid substance becomes lodged in the lungs, it will cause severe irritation and difficulty breathing.

Entry of food and liquids in the airways causes

Causes of aspiration are described from most to least common below. Causes include dysphagia, stroke, oral or dental problems, neurologic illness, among others.


This is a term for difficult or abnormal swallowing.

  • Swallow malfunction (dysphagia): This involves a malfunction in the system which normally closes off your airway when you swallow. When it remains partially open, food or liquid can get into the airway and travel down to the lungs.
  • Acid reflux: When there is acid reflux (also called gastroesophageal reflux disease (GERD) or heartburn), dysphagia may allow food or liquid to come back up from the stomach and enter the lungs that way.

Airways questionnaire

Use our free symptom checker to find out what's causing your airways.

Airways symptom checker


Strokes can cause damage to the parts of the brain which control reflexes — including the swallowing or "gag" reflex. This can lead to dysphagia and aspiration.

Oral or dental problems

Oral or dental problems can cause difficulty swallowing as the person tries to work around them.

  • Broken, missing, or painful teeth
  • Sores or other damage to the inner surface of the mouth

Neurologic illness

Neurologic illnesses can interfere with reflexes and muscle control. Normal swallowing requires both.

Rare and unusual aspiration causes

Rare and unusual causes of aspiration may include:

  • Birth injury: Oxygen deprivation can lead to brain damage and therefore a lack of proper swallowing reflexes and muscle control.
  • Birth defects: Cleft palate, for example, can make swallowing difficult.
  • Abnormal growths: Those in the throat and neck, and/or a history of receiving radiation treatments to the same area can lead to aspiration.

This list does not constitute medical advice and may not accurately represent what you have.


Achalasia is a disorder of the esophagus, the tube that carries food from the mouth to the stomach. This condition affects the ability of the esophagus to move food into the stomach.

Rarity: Ultra rare

Top Symptoms: pain below the ribs, regurgitation, unintentional weight loss, heartburn, deep chest pain, behind the breast bone

Urgency: Primary care doctor

Stroke or tia (transient ischemic attack)

Transient ischemic attack, or TIA, is sometimes called a "mini stroke" or a "warning stroke." Any stroke means that blood flow somewhere in the brain has been blocked by a clot.

Risk factors include smoking, obesity, and cardiovascular disease, though anyone can experience a TIA.

Symptoms are "transient," meaning they come and go within minutes because the clot dissolves or moves on its own. Stroke symptoms include weakness, numbness, and paralysis on one side of the face and/or body; slurred speech; abnormal vision; and sudden, severe headache.

A TIA does not cause permanent damage because it is over quickly. However, the patient must get treatment because a TIA is a warning that a more damaging stroke is likely to occur. Take the patient to the emergency room or call 9-1-1.

Diagnosis is made through patient history; physical examination; CT scan or MRI; and electrocardiogram.

Treatment includes anticoagulant medication to prevent further clots. Surgery to clear some of the arteries may also be recommended.

Rarity: Common

Top Symptoms: dizziness, leg numbness, arm numbness, new headache, stiff neck

Symptoms that never occur with stroke or tia (transient ischemic attack): bilateral weakness

Urgency: Emergency medical service

Esophageal obstruction (steakhouse syndrome)

When a large piece of food or an object gets stuck in the lower esophagus, it can produce some mild chest pain and excessive salivation (drooling).

Rarity: Rare

Top Symptoms: vomiting, deep chest pain, behind the breast bone, trouble swallowing, choking, swallowing of something potentially harmful

Symptoms that always occur with esophageal obstruction (steakhouse syndrome): swallowing of something potentially harmful

Urgency: Hospital emergency room

Parkinson's disease

Parkinson's disease is a lifelong condition movement disorder. It is caused by the malfunction and death of nerve cells which results in symptoms like tremors.

Rarity: Rare

Top Symptoms: anxiety, depressed mood, difficulty concentrating, nausea, constipation

Symptoms that always occur with parkinson's disease: symptoms of parkinsonism

Urgency: Primary care doctor

Multiple sclerosis (ms)

Multiple sclerosis, or MS, is a disease of the central nervous system. The body's immune system attacks nerve fibers and their myelin covering. This causes irreversible scarring called "sclerosis," which interferes with the transmission of signals between the brain and the body.

The cause is unknown. It may be connected to a genetic predisposition. The disease usually appears between ages 20 to 50 and is far more common in women than in men. Other risk factors include family history; viral infections such as Epstein-Barr; having other autoimmune diseases; and smoking.

Symptoms include numbness or weakness in arms, legs, or body; partial or total loss of vision in one or both eyes; tingling or shock-like sensation, especially in the neck; tremor; and loss of coordination.

Diagnosis is made through patient history, neurological examination, blood tests, MRI, and sometimes a spinal tap.

There is no cure for MS, but treatment with corticosteroids and plasma exchange (plasmapheresis) can slow the course of the disease and manage symptoms for better quality of life.

Rarity: Rare

Top Symptoms: severe fatigue, constipation, numbness, decreased sex drive, signs of optic neuritis

Urgency: Primary care doctor

Amyotrophic lateral sclerosis (als)

Amyotrophic lateral sclerosis is also called ALS or Lou Gehrig's Disease named after the Hall of Fame baseball player whose career ended when he developed ALS. It is a degenerative disease that destroys nerve cells, which eventually ...

Entry of food and liquids in the airways treatments and relief

As long as aspiration is not preventing normal breathing or occurring along with a fever, treatments and methods of prevention can begin at home.

At-home treatment

At-home remedies can be used to limit or prevent the occurrence of aspiration.

  • Positioning: Try sitting up straight while eating and limit distractions.
  • Portioned bites: Try taking smaller bites and sips of food and drink.
  • Slow down: Try to consume food at a slower pace.

Airways questionnaire

Use our free symptom checker to find out what's causing your airways.

Airways symptom checker

When to see a doctor

You should consult your physician for the following, who may recommend further treatment:

  • Recurrent episodes of pneumonia
  • Repetitive actions: Such as onstantly clearing the throat, coughing, or feeling as though you are choking while eating
  • Severe and recurrent heartburn: Especially if there is also trouble swallowing
  • Physical therapy: You may be referred to a physical therapist who can help with swallowing difficulties.

When it is an emergency

You should seek treatment without delay if:

  • You or someone you are with is having extreme difficulty breathing: Especially with blue-tinged lips or severe distress
  • You or someone you are with is running a fever and is having painful, troubled breathing

FAQs about entry of food and liquids in the airways

How long does aspiration pneumonia take to develop?

Aspiration pneumonia is a pneumonia caused by inhalation of some substance, usually saliva or food and occassionally stomach contents. The bacteria from the mouth then reach the lungs and are allowed to grow if the immune system is compromised or a particularly large number of bacteria are allowed to reach the lung. Aspiration pneumonia can take up to a day or two to develop lung symptoms after the aspiration event.

Are choking and aspiration the same thing?

No. Choking is an inability to breathe because of blocking of the windpipe or larynx. Choking can cause unconsciousness and death within minutes. Aspiration is inhalation of something that is lodged in a portion of the lung or distal airway. It can compromise a portion of the lung but does not refer to blockage of an entire lung.

Can aspiration cause death?

Yes, aspiration — especially of caustic chemicals, including stomach acid, or smoke — can cause sufficient damage to the lung resulting in death. Additionally, reactions to aspirated substances can cause acute respiratory distress syndrome (ARDS) which can lead to inability of the lung to properly transfer inhaled oxygen into the blood through destruction of lung membrane.

What are the aspiration precautions?

For an individual with trouble swallowing, a medical professional may recommend a diet that has a thicker consistency, as thinner fluids carry higher risks of aspiration. An example would be patients who suffered a stroke that damaged their swallowing abilities or gag reflex. For individuals in areas with dangerous particles (e.g. firefighters in smoky rooms, healthcare professionals around tuberculous patients), a facial mask usually referred to as an N95 respirator may be used.

What is silent aspiration in infants?

For children who are developmentally delayed or who have repeated aspiration events, the cough or gag reflex may become diminished and coughing, choking, or gagging may be less evident or not evident at all. When a child shows no reflexive (coughing, gagging, sputtering) signs of aspiration, but is found to have aspirated, this is called silent aspiration.

Questions your doctor may ask about entry of food and liquids in the airways

  • Have you ever been diagnosed with Parkinson's disease?
  • Have you had any changes in your weight?
  • Do you have a cough?
  • Any fever today or during the last week?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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