Can’t breathe after eating

Shortness of Breath After Eating

Q1. Lately I’ve noticed a feeling of pressure just under my breastbone a short time after eating. My heart starts beating funny and I seem to get out of breath – I have to take some deep breaths. There is no pain, just pressure. What could be causing this?

First things first: Anyone with chest pressure, an abnormal heartbeat, or shortness of breath MUST see his or her doctor immediately to rule out serious heart conditions that can cause these symptoms, including arrhythmias, valve disease, coronary artery disease, and pericarditis. If this workup is negative, your doctor should then examine your lungs. If both heart and lung tests are negative, there is a chance that a gastrointestinal disorder is causing your symptoms.

Some of the digestive disorders that can cause chest pain include gastroesophageal reflux disease (GERD) and motility disorders, such as diffuse esophageal spasm, achalasia, and other, less common syndromes. Your doctor may prescribe a gastrointestinal workup, perhaps including a barium swallow (an X-ray test), endoscopy, and/or an esophageal motility study.

Q2. I’ve always been very constipated and if I don’t drink “dieter’s tea” I won’t go to the bathroom. I have tried Metamucil and healthy fiber as alternatives, but nothing else works. Is dieter’s tea bad in the long term?

— Lucerito, California

Unfortunately, so-called dieter’s tea is not regulated by the Food and Drug Administration (FDA). It can be obtained at health food stores, on-line, or through mail-order catalogs. You should know that the FDA has received adverse reports related to dieter’s teas, including the deaths of four young women in whom dieter’s tea may have been a contributing factor.

While some studies have shown that dieter’s teas may be better than placebo in relieving constipation, they contain a variety of plant-derived laxatives that may cause long-term harm. For example, many dieter’s teas contain senna, a stimulant that causes the nervous system of the gut to release neuropeptides (nerve proteins that regulate and link our body systems). These promote defecation by increasing movement of the gut or stimulating fluid secretion. Long-term use of stimulants such as senna may deplete the gut of these neuropeptides and ultimately lead to worsening of long-term constipation. In other words, dieter’s teas do carry a long-term risk of harm; I would recommend you opt instead for fiber products, mineral oil as a safe stool softener, or an osmotic agent such as lactulose, sorbitol or MiraLax as they are safer in the long term. Mild constipation can also be treated by an increase in drinking liquids, physical activity, and behavioral changes that normalize the time of day when defecation is attempted.

Q3. Is it true that if you have celiac disease, you should not eat condiments that contain white vinegar? What about distilled vinegar – is that safer?

— Jill, Ontario

White vinegar and most vinegars are typically distilled; the distillation process removes all gluten products. In the United States, vinegars are routinely distilled and made typically from corn, potatoes, or other food substances, but even distilled vinegars made from wheat are safe for people with gluten intolerance because the gluten products are removed in the end product. However, exceptions include malt vinegars (made from barley); flavored vinegars, which may contain gluten; and some imported vinegars that have wheat products added after distillation. Vinegars used in condiments made in the United States are typically safe for patients with celiac disease.

Q4. I was recently diagnosed with fructose malabsorption disorder. It’s been really tough to control my diet, since fructose is in so many products. Any advice?

Fructose malabsorption has been thought to be relatively rare compared with malabsorption of other sugars, particularly lactose. There is an inherited form of fructose malabsorption, but it is very rare and is related to a mutation in a specific gene (GLUT5) that normally makes a protein that helps transport fructose in the digestive tract. However, in recent studies malabsorption of fructose and another sugar, sorbitol, has been found in a number of patients who had previously been diagnosed with irritable bowel syndrome. In addition, there appears to be overlap between fructose malabsorption and celiac sprue, an inflammatory condition of the small bowel that is treated by avoiding gluten, a component of wheat products. For this reason, adults who are found to have fructose malabsorption disorder should also be tested for celiac sprue.

Regarding treatment, you’re doing the right thing to avoid foods that have high fructose content. I know that means work on your part, since so many foods contain fructose (including high-fructose corn syrup). Try in particular to avoid fruits and fruit products that have high fructose levels — such as apple juice, pears, peaches, and prunes — and limit your intake of foods that contain high levels of sucrose (table sugar) as well, since sucrose also contains fructose, although in a bound form that is somewhat easier to tolerate for patients with fructose malabsorption.

Learn more in the Everyday Health Digestive Health Center.

The respiratory system is the system of organs that allow the body to take in oxygen and expel carbon dioxide, this process is known as gaseous exchange.

We generally breathe between 12 and 20 times a minute. There are a number of complications of diabetes that can negatively affect our breathing.

Parts of the respiratory system

The following parts of the body make up the respiratory system:

  • Mouth and nose
  • Trachea (windpipe)
  • Lungs
  • Diaphragm

How the respiratory system works

Breathing is usually initiated by contraction of the diaphragm, a muscle which separates the chest cavity from the abdomen.

As the diaphragm contracts, more space is made available in the chest cavity and this has the effect of creating suction as the lungs expand to fill the space.

The lungs draw in air through the nose and/or mouth which then travels down the trachea (windpipe) before reaching the lungs.

Within the lungs are tiny air sacs called alveoli which allow oxygen from the air we breathe to be absorbed into the many tiny blood vessels contained with the alveoli.

As this happens, the alveoli take in carbon dioxide from the blood vessels and this completes gaseous exchange.

With gaseous exchange complete, the diaphragm relaxes and the carbon dioxide rich air in the lungs is expelled via the trachea out of the mouth and/or nose.

The lungs

As noted above, it is within the lungs that the gaseous exchange of oxygen and carbon dioxide takes place. The lungs are filled with a branched structure of airways called bronchi and smaller airways called bronchioles. Located at the end of the bronchioles are the alveoli in which the exchange of gases takes place.

The average capacity of human lungs is between 4 and 6 litres of air. The capacity of lungs may be reduced if the lungs become diseased or damaged. A common risk of lung damage is smoking

How diabetes can affect the respiratory system

Diabetes can adversely affect our breathing in a number of different ways. Breathing difficulties don’t affect everyone with diabetes and the risk of having difficulty breathing can be reduced by maintaining good diabetes control and a healthy body weight

Ketoacidosis and Kussmaul breathing

Rapid or laboured breathing, known as Kussmaul breathing, can be a symptom of diabetic ketoacidosis (DKA). Ketoacidosis is a short term complication of diabetes caused by very high blood glucose levels accompanied by a high level of ketones in the blood. Ketoacidosis will only usually affect people with diabetes if they haven’t taken sufficient insulin.

Ketoacidosis is a very dangerous condition and should be treated as an emergency.

  • Read more about diabetic ketoacidosis

Kidney failure and shortness of breath

Becoming very short of breath, say whilst climbing the stairs, can be a result of kidney failure. Chronic kidney disease can lead to anemia which leaves the blood short of red blood cells with which to carry oxygen. If we have anemia and need to be more active, this can lead to our body struggling to get enough oxygen for our muscles and can leave us out of breath.

Kidney disease is one of the more common complications of diabetes, affecting about 40% of people with diabetes.

  • Read more about diabetic kidney disease

Obstructive sleep apnea (OSA)

Obstructive sleep apnea (OSA) is a condition that results in difficulty breathing whilst sleeping. This can happen if the muscles in the throat collapse inwards and block your airway. This may happen partially or completely and can therefore disturb sleep.

Being overweight is the main risk factor of sleep apnea and the NHS notes that people with diabetes have a 3 times higher risk of developing sleep apnea.

  • Read more about obstructive sleep apnea

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Shortness of breath after eating can be an uncomfortable or distressing experience, but is usually not a cause for concern.
There are many possible reasons why a person may feel out of breath after eating, and the treatments differ depending on the cause.

This article outlines some of these causes, along with information on treatments and when to see a doctor.

1. Food allergies
The American College of Allergy, Asthma & Immunology estimate that 4 percent of adults and 4–6 percent of children in the United States have a food allergy. Most symptoms arise within minutes or hours after eating.

Shortness of breath after eating is one of several symptoms associated with food allergies.

People who suspect a food allergy can talk to their doctor. A doctor can diagnose food allergies by doing safe tests. Tests may include an oral food challenge, which involves a person eating small amounts of the suspected trigger food.

The best way to prevent allergic reactions is to avoid trigger foods. There is no treatment for food allergies, but researchers are currently carrying out clinical trials to try to work out how people can build up a tolerance for specific foods.

Anaphylaxis
Shortness of breath can indicate a rare but potentially life-threatening allergic reaction known as anaphylaxis. People who experience anaphylaxis require urgent medical attention.

The signs and symptoms of anaphylaxis include:

shortness of breath
repetitive coughing
a weak pulse
hives, rashes or swelling on the skin
tightness in the throat
a hoarse voice
difficulty breathing or swallowing
nausea, vomiting, or diarrhea
abdominal pain
a feeling of doom
rapid heart rate
low blood pressure
dizziness or fainting
cardiac arrest
People with severe allergic reactions need to carry an EpiPen, which is a medical device that allows people to self-inject epinephrine to counteract the allergic reaction. People should phone the emergency services after delivering the injection.

2. Inhaling food particles
Occasionally, people may inhale small particles of food or liquid while eating. This is called pulmonary aspiration.

People with healthy lungs are usually able to cough up these particles. Coughing can cause short-term shortness of breath, and possibly a sore throat.

When a person’s lungs are not healthy enough to cough up the particles, they may develop aspiration pneumonia. This occurs when the particles cause an infection inside the air sacs of one or both lungs.

Symptoms of aspiration pneumonia include:

chest pain
wheezing
shortness of breath
a cough producing foul-smelling, green, or bloody phlegm
unpleasant breath odor
difficulty swallowing
fever
excessive sweating
fatigue
Treatment for aspiration pneumonia depends on a person’s overall health and the severity of their condition. In most cases, a doctor will prescribe antibiotics to treat the infection.

3. A hiatus hernia

A hernia occurs when an organ or tissue squeezes into a part of the body where it does not belong.

A hiatus hernia is where the stomach bulges up into the chest through the wall of muscle that separates the diaphragm and the abdomen. A hiatus hernia can cause shortness of breath that worsens after eating.

A paraesophageal hernia is a type of hiatus hernia that occurs when the stomach squeezes up next to the food pipe. If it grows too big, it can push on the diaphragm and squash the lungs, causing chest pain and shortness of breath. These symptoms may be worse after eating, as a full stomach increases the pressure on the diaphragm.

Some paraesophageal hernias do not require treatment. However, a person may require surgery if they experience the following symptoms:

chest pain
pain in the middle or upper abdomen
difficulty swallowing
stomach ulcer
GERD
A surgeon will usually repair a paraesophageal hernia using keyhole surgery, or laparoscopic surgery. They will place a tiny lighted camera, called a laparoscope, into the food pipe to view and move the stomach back into position.

Laparoscopic surgery is a minimally invasive procedure, and most people make a full recovery within 4 weeks.

4. GERD-related asthma
People who have asthma may experience shortness of breath after eating, particularly if they also have gastroesophageal reflux disease (GERD).

What is asthma?

Asthma is a disease affecting the airways within the lungs. In asthma, allergens or irritants entering the lungs cause the airways to narrow. This triggers a range of respiratory symptoms, including:

shortness of breath
wheezing
coughing
tightness in the chest
What is GERD?

GERD is a digestive disorder affecting the muscles in the food pipe, which is the tube that connects the mouth and stomach.

Typically, the muscles in the food pipe get narrower to keep the food in the stomach after eating. When a person has GERD, these muscles do not close up completely, which allows stomach acid and partially digested food to travel back up into the food pipe. This acid reflux can cause heartburn.

What is the link between GERD and asthma?

An estimated 89 percent of people with asthma will also experience GERD.

In GERD-related asthma, stomach acid irritates the nerve endings in the food pipe. The brain responds by narrowing the small airways in the lungs, which triggers asthma symptoms.

Sometimes, a person might inhale some stomach acid into their lungs. This irritates the airways and can cause breathing difficulties, coughing, and chest tightness.

Treatment

The key to treating GERD-related asthma is to treat acid reflux. Treatments include:

over-the-counter medications (for example, Zantac-75, Pepcid A-C)
eating five or six small meals a day rather than three large meals
wearing loose clothing around the waistline
avoiding lying down within 3 hours of eating
quitting smoking
People with GERD may also choose to avoid the following foods, which may trigger acid reflux in some people:

fried and fatty foods
alcohol
caffeinated drinks
chocolate
peppermint
citrus fruits
onions
garlic
tomato-based products
spicy foods

5. COPD

COPD, or chronic obstructive pulmonary disease, is a progressive lung disease that makes it difficult for the body to move air into and out of the lungs.

People with COPD may experience shortness of breath resulting in reduced energy levels. This can make everyday activities difficult.

Because breathing and digestion both require a lot of energy, some people with COPD may become breathless after eating meals.

Other common symptoms of COPD include:

frequent coughing
tightness in the chest
wheezing
Having a full stomach or a bloated abdomen can worsen breathing difficulties in people with COPD. People may notice improvements in their symptoms if they eat small, frequent meals instead of fewer large meals, and avoid foods that cause gas and bloating.

The COPD Foundation offer some other tips for reducing shortness of breath after eating, including:

resting for 30 minutes before and after a meal
eating slowly
reducing sugary foods that can cause tiredness
avoiding lying down after meals
avoiding eating while short of breath as this can trap gas, which worsens breathing difficulties.

When to see a doctor
People who experience ongoing shortness of breath after meals should see a doctor. The doctor will conduct tests to determine the underlying cause and may prescribe medications to alleviate symptoms.

Sometimes, shortness of breath can indicate a serious underlying medical condition. According to the American Lung Association, it is important to seek medical attention if shortness of breath occurs while at rest, lasts longer than 30 minutes, or occurs alongside any of the following:

pain or pressure in the chest
difficulty breathing when lying flat
wheezing
lightheadedness or dizziness
fever, chills, and cough
blue tinge to the lips or fingertips
swelling of the feet or ankles
Summary
Breathing difficulties that occur after eating may be a one-off symptom caused by breathing in a small particle of food or liquid.

However, people who experience shortness of breath after every meal, or after eating certain foods, should see a doctor to find out the cause. Treatment will depend on the underlying cause of breathlessness.

Sometimes, breathing difficulties can suggest a serious underlying medical condition. It can help to know the signs and symptoms that indicate a need for urgent medical attention.

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    With infants and toddlers being so fragile, it’s no wonder parents are so anxious and protective during their first few years. However, not even the most protective of parents could have foreseen that a piece of bread would cut short this four-year-old girl’s life.

    On March 25 at 5pm, four-year-old Lim started having trouble breathing after her mother, Teoh, fed her a piece of bread. Prior to that, Lim, who was born with Down syndrome, had contracted a high fever, following which Teoh brought her to the doctor and gave her medication. However, the fever persisted, and the little girl’s temperature kept fluctuating.

    Source: Sin Chew

    “She didn’t finish drinking her milk, so I gave her some bread to eat. However, she suddenly started crying and yelling after taking one or two bites. I noticed she was having trouble breathing, and immediately called my father.” Teoh told Sin Chew.

    Teoh’s mother, who had just returned home from picking up her six-year-old grandson, saw Lim’s terrible condition and quickly rushed her and her mother to the University of Malaya Medical Centre. “Just as we had reached the traffic light in front of the hospital, my granddaughter gripped my arm, and then she just stopped breathing. The doctor tried to resuscitate her, but she was already gone.”

    Source: Sin Chew

    Sin Chew also reports that Teoh blames herself for her daughter’s death, saying that if she hadn’t fed her the bread, things might not have turned out this way.

    Aside from her mother and grandparents, Teoh is survived by her older brother, the aforementioned six-year-old boy. Her father had passed away last year due to high blood pressure, and both children would be put under the care of their grandmother while their mother was at work.

    Lim’s body remains at the hospital, where a post mortem examination is being carried out to determine the cause of death.

    Our hearts go out to Lim’s family, and we would like to extend our deepest condolences to them. Hug your family members a little tighter tonight, or tell them ‘I love you’ one more time because you simply never know when it’ll be too late to do either things again.

    Also read: Father Leaves 2yo Down Syndrome Son with Nanny, Refuses to Take Him Back After 1 Year

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    • What Are the Causes of Shortness of Breath After Eating?

      Anxiety disorders are psychological illnesses characterized by intense fear, paranoia, panic and/or restlessness that detract from a person’s ability to function normally. Though symptoms of anxiety disorders, such as panic disorder, obsessive compulsive disorder, phobias and generalized anxiety disorder, vary, shortness of breath and difficulty breathing are common. If a person’s anxiety involves food, weight or other dietary issues, meals may trigger shortness of breath and/or other symptoms, such as a rapid heartbeat, dizziness, nausea, chest pain and intense fear. Anxiety disorders often accompany other disorders, such as anorexia, according to the National Institute of Mental Health. Anorexia and other mental illnesses, such as depression, bulimia and binge-eating disorder, may increase a person’s risk for experiencing shortness of breath after eating. Treatment for anxiety disorders varies and may include individual counseling, medications and/or alternative therapies, such as meditation or massage.

      • Reference Number: HEY-935/2017
      • Departments: Speech and Language

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      Introduction

      This leaflet has been produced to give you and your family general information about some of the eating and drinking difficulties you may experience as a result of having respiratory difficulties. Most of your questions should be answered by this leaflet. It is not intended to replace the discussion between you and the Speech and Language Therapist, but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for you.

      What is dysphagia?

      • Dysphagia means ‘a swallowing difficulty’.
      • As many of the muscles involved in swallowing and breathing have dual roles (Shaker et al1992), problems in one may lead to a difficulty in the other.
      • There are risks associated with having dysphagia including, aspiration (food going down into your lungs), choking, poor nutrition and reduced quality of life.
      • It is common for individuals with breathing difficulties to have problems eating and drinking. 27% of people who suffer from COPD (Chronic Obstructive Pulmonary Disease) have a dysphagia. (McKinstry et al 2009).

      How is swallowing linked to breathing?

      For this process to occur well, the body must also co-ordinate the breathing cycle with the swallow. The swallow temporarily interrupts breathing. The moment you swallow, you must momentarily hold your breath to close the airway (this prevents any food or fluid from entering the lungs). The usual cycle is:Swallowing is a highly complex process involving the coordination of more than 26 muscles and 6 nerves. We swallow around 600 times a day and the normal pattern of swallowing happens quickly and should only take a few seconds to complete.

      Breathe out –> hold breath to protect airway approximately 1 – 1.5 seconds (apnoeic episode) –> swallow –> continue to breath out a little –> breathe in –> repeat.

      People who have a breathing difficulty may breathe in after swallowing rather than breathe out. This can increase the risk of food and drink being inhaled into the open airway (Shaker et al 1992). Additionally, if you have difficulties triggering a strong cough, this may reduce your ability to sufficiently protect your airway if something went down the wrong way.

      How could this affect you?

      • Muscles feel tired and weak.
      • An increased rate of breathing during eating and drinking can increase the likelihood of food and drink going down the wrong way. This may also cause a chest infection.
      • If you have a breathing problem, you may require oxygen therapy and wear an oxygen mask. This may make eating and drinking more difficult.
      • Dry mouth (xerostomia) is common if you wear an oxygen mask or you mouth breathe. Chewing and clearing food from your mouth can be difficult when you suffer from xerostomia.
      • Breathing difficulties have been linked to the increased likelihood of bringing food and drink back up from the stomach (this is called reflux but is commonly known as indigestion). Sometimes this can come up from the stomach and enter into the airway from the food pipe; you may feel bloated or experience belching. It may also cause irritation in the airway or cause you to cough.
      • An increased work of breathing uses up more energy and muscles can tire quickly. If you are exhausted or feel weak you may find that it takes longer to complete your meals and you may eat and drink less. This may mean you miss out on important nutrients and/or lose weight.

      Signs that you may have respiratory dysphagia

      • Increased shortness of breath during mealtimes.
      • Reduced appetite.
      • Difficulty chewing and avoiding difficult textures e.g. chewy/crunchy foods.
      • Wet or gurgly voice during and/or after swallowing.
      • Taking much longer to complete a meal.
      • Sensation of food sticking in the throat.
      • Increased work of breathing.
      • Getting tired during and after eating and drinking.
      • Anxious when eating or drinking.
      • Experiencing a sensation of feeling ‘full-up’ even though you have only eaten very small amounts.
      • Experiencing more acid indigestion (reflux).
      • Coughing during or just after eating and drinking.
      • Chestiness or recurrent chest infections.
      • Difficulties taking tablets.

      Advice on how you can help:

      Before eating and drinking

      • If you can have your oxygen via nasal cannula this would be preferable whilst you are eating and drinking. If you use a face mask, it may be helpful for someone to assist you at mealtimes.
      • Making sure that your mouth is clean and moist by regularly brushing your teeth and gums (or clean your dentures) to reduce bacteria build up in your mouth – speak to your nurse/GP if you need saliva replacement products.
      • It is very important that you sit fully upright, if you need assistance achieving this please ask someone to help you.
      • If you have secretions stuck in your throat/back of mouth, try to cough to clear these first. Speak to a nurse if you require assistance clearing your secretions.
      • If you wear dentures make sure these fit well and are comfortable, if they are loose or ill-fitting they may cause more of a problem.
      • Ensure you have easy access to all your cutlery and food.
      • It would be helpful to have a relaxed and comfortable environment during mealtimes – turn off any distracting music/tv etc and avoid talking whilst eating and drinking. Try to relax your whole body as much as possible.
      • Make sure you are well rested before eating and drinking. Be aware that food preparation may be tiring.
      • If you are extremely breathless please seek advice from a medical professional as eating and drinking may become very difficult.

      During and after eating and drinking

      • Do not use spouts or straws unless they have been specifically recommended.
      • Eat slowly and take smaller mouthfuls. It may help to take softer foods which require less chewing.
      • If your mouth is feeling dry, take a sip of fluid when you need to but be aware that alternating drinks with mouthfuls of food may be difficult.
      • You may benefit from doing an extra swallow to clear any food residue.
      • Avoid continuous drinking; ensure you take one sip at a time.
      • Attempt to breathe out immediately after a swallow.
      • You may find eating little and often easier. Select high calorie options if you are struggling to eat enough.
      • If you are concerned about your nutrition you can ask the nurse or dietitian about what extra snacks are available.
      • Remain upright for at least 30 minutes after a meal.

      If you experience reflux or heartburn, discuss anti-reflux medication with your doctor or GP. If you have been prescribed reflux medications ensure you are taking these correctly.

      Credit is to be given to Leeds Community Healthcare NHS Trust for the supply of additional content to produce this leaflet. This final copy was produced by the Speech and Language Therapy Department, Hull University Teaching Hospitals NHS Trust with the help of a Speech and Language Therapist in Northumberland, Tyne and Wear.

      General Advice and Consent

      Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

      Consent to treatment

      Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

      The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

      • you must be able to give your consent
      • you must be given enough information to enable you to make a decision
      • you must be acting under your own free will and not under the strong influence of another person

      Information about you

      We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

      We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

      Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

      If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.

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