Coughing Up Food, Constantly Clearing Throat

CherelleV Asked :

I am a 27 year old female and recently when I cough I find some food particles collect in my mouth. It doesn’t always happen but it is often. If I am alone I spit out these particles and they look like small grains of rice – more like risotto rice grains. They are almost white and very soft. Its not tonsil stones. If I smell it closely it has a terrible odor, like something rotting. I am worried because I am not sure where this is coming from. I don’t even eat much rice.

The other problems that I have been experiencing recently is like a a dull ache of the throat. It’s not a sore throat but I think this may be related to my acid reflux which has been a problem for years. I had these types of throat irritation before but now I constantly feel like I need to clear my throat and while I know it is not very polite to do so in public, I can’t help it. This has become a bit awkward and sometimes when I hold it in I feel like I am going to gag. Sometimes when I clear it I get some mucus collecting at the back of the throat.

I have seen two doctors and they both gave me a different diagnosis. The first doctor said that I was coughing up food particles that were coming from my stomach due to the GERD. He also said the throat ache is due to the rising gastric acid at night. He gave me some meds for acid reflux – it helped a little but after completing, it has stayed the same.

Another doctor says that I have chronic tonsillitis which is worse due to my post nasal drip and that food particles are getting stuck in the tonsils. He told me to take out my tonsils because my they are practically eaten up. I refused so he put me on a long course of antibiotics, nasal spray and so on. He told me to stop smoking, which I did somewhat, but the symptoms never went down and I went back to smoking. I have only been smoking for 3 years and I don’t have a smoker’s cough or anything.

So what could be the problem and what’s next?

This question was posted under the Causes of Chronic Cough – Persistent, Constant Coughing article.

Any response by the Health Hype team does not constitute a medical consultation and the advice should be viewed purely as a guide. Always consult with your doctor before making any changes to your current treatment program. The information provided in this article is not an authoritative resource on the subject matter and solely intends to guide the reader based on the questions asked and information provided.

Dr. Chris Answered :

It is most likely that both your doctors are correct but looking at the problems separately. Post nasal drip often aggravates a case of tonsillitis and so does GERD. Rising gastric acid, especially when you are sleeping, irritates the already inflamed tonsils. Food easily gets trapped in the tonsillar crypts of the swollen tonsils. When you cough, these food particles are pushed out of the tonsils and into your mouth.

The second doctor may mean that parts of your tonsils are becoming necrotic (What is Necrosis?)and in this case it should be removed. If left untreated, it can be prone to repeated infections, affect surrounding healthy tissue, cause bad breath (halitosis) and lead to a host of complications – some of which can be serious. Treatment of the condition will only be effective in the short term. Regurgitating food as a result of GERD is a possibility but it would not always be these small specks and it should mainly occur in the mornings or after sleep.

In terms of the ‘rice’ – it may not actually be rice. Small specks of food may be getting trapped in the tonsillar crypts where it decays slightly and coalesces into these ‘grains’ that you see. As with any decomposing matter, it smells putrid. The mucus may be as a result of the post nasal drip or it could be exudate from the tonsils itself. The irritation caused by the inflamed tonsils plus the ‘dripping’ mucus as a result of post nasal drip will constantly give you that urge to clear the throat.

You need to see an otolaryngologist (ENT specialist) who will  be able to examine the area better and decide on the most appropriate course of treatment. In all likelihood a tonsillectomy may be necessary. Take note that tobacco smoking will aggravate your tonsillitis, post nasal drip and GERD.

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  • Alexs Parson

    I have suffered with heart burn since I was about 15 years old.
    I’ve had an ulcer cured by antibiotics in hospital for 7 days when I was 23. I’m now 38 and have had bad heart burn all along; I then noticed I had bad breath too.
    I tried a few things but didn’t really get anywhere. A friend told me to get advice from *Name Removed* Labs as it worked for him. Interestingly *Name Removed* Labs specializes in bad breath but considers Bad Breath, Halitosis, Post Nasal Drip, Dry Mouth, GERD and heartburn as a single health issue and have you treat all of them in your own home by yourself. It mentioned most people who complain of one problem actually had most or all of the other problems but didn’t know it. So it gets you to attend to all of them as missing one usually results in the return of the other. Anyway I’ve been following there advice for about 2 months now I feel much better even sleep better, so I think people suffering from any of the 5 problems to consider giving *Name Removed* Labs a go. I now know I had most of the problems it focuses on and each problem was helping the other problem.

  • advisor

    I have had this happen to me, with the aching if its on a certain side or even on either, you might have a bigger piece of food stuck in your tonsils. The reason why it aches is because the food is still decaying,and in that your tonsils react, or you could get a waterpik to remove any unwanted objects in your throat, not saying your doctors are wrong they can sometimes over look and mistake something for another.

  • irene

    My mum died almost 3 yrs ago now, I am an only child, and unfortunately, have no family in England left. My Family are now in Arizona USA. The thing is, I knew that my mums’ death would affect me badly but amazingly, I have plodded on alone except that is affecting my health. When walking just a short way say a block of houses, I find it hard to breath, and my legs ache terribly. I have been to my G.P. and have been diagnosed with gall stones, but now I have had a blood test & my liver, pancreas, kidneys etc., are all in working order and my blood is fine. My G.P. also examined my lungs & heart. She said this is caused by not having anywhere to go, and when I do go out, I panic, but I am still not happy, because my ankles & legs swell, not very often but say if I sit a my pc for too long. Have I reason to worry, my G.P. certainly isn’t & I should feel over the moon that my organs are functioning well but I cannot get this worried feeling out of my mind, and worrying is what I shouldn’t be doing. I also have a bad cough, which I have had for several years, but it was through the coughing that helped the gall stones be found.

    • Dr. Chris

      Hi Irene

      If it wasn’t for the leg swelling and since all the tests were clear, it would most likely have been a case of anxiety/panic attacks. You may have an anxiety disorder that would respond well to medication and this should be considered along with counseling. However, the leg swelling does raise concerns about your peripheral circulation and this should also be explored further. Depending on your age, weight, past medical history and so on, this may be an early indication of something more serious – for example : leg swelling and coughing could be an indication of heart failure. But as mentioned, much of your symptoms can be explained by an anxiety disorder as well.

  • Laby

    I have the exact same problem as CherreleV, but it’s not tonsillitis. I find its hard to cough and when I did, white “grain of rice” came out when I didnt eat any rice. I live with dogs and cats- it it be I got infested with their parasites and coughing off parasites eggs?

    • Hi Laby. Even if its not typical acute tonsillitis (with the swelling, pain and so on) It could still be a tonsil problem but a more chronic condition where parts of the tonsillar tissue has been eroded. Be it from repeated infections or rising stomach acid (GERD), the tonsillar tissue is easily damaged slowly with little symptoms being evident in the early stages.

      Food particles can then collect in these small cavities, decompose to some degree and be coughed up. It looks like rice particles but it is not necessarily rice. These particles typically have an offensive odor but not always. You should still see an ENT specialist as soon as possible. The possibility of this being parasite eggs that are coughed up is very unlikely.