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Coughing up food is a symptom that can occur in cases of chronic tonsillitis or  swollen tonsils. (tonsillar hypertrophy)  where the tonsils have now become enlarged, pitted or ulcerated. This allows food to be trapped between the tonsils and oropharyngeal (mouth-throat) wall or within tiny pits and ulcers  on the surface of the tonsils. When coughing, tiny remnants of food dislodge from the tonsillar pits and are expelled into the mouth or through the mouth. Very often these small food particles may look like soft white speckles (similar to a small rice grain) and may have a slightly foul odor as it is decomposing food (some patients report a ‘garbage can’ odor). If they remain trapped in the crevices of the tonsils over a long period, they may begin to harden and are called ‘tonsil stones‘.

Both soft food particles and tonsil stones can be coughed up or even ‘picked’ out of the tonsil with a tooth pick. This may be common in both children and adults.

Coughing up small particles of food in this instance should not be mistaken with vomiting during or after  coughing. Vomiting may occur as a result of a full stomach that is put under pressure when you cough. This causes the gastric contents to be forced up the food pipe (esophagus) and then the gagging and vomit reflex is triggered. In some cases like hiatus hernia, the gastroesophageal valve which separates the food pipe from the stomach cannot separate the two areas adequately and food may rise up the esophagus causing heartburn. Slight coughing may force some of the gastric contents to be expelled.

Chronic swollen tonsils (hypertrophic tonsils) have a number of causes, one of which is tonsillitis, an infection of the tonsils thereby causing tonsillar enlargement.

Causes of Swollen Tonsils

  • GERD (gastroesophageal reflux disease). Inflammation of the tonsils due to rising gastric acid during sleep. Patient notices a recurrent morning sore throat.
  • Post nasal drip
  • Smoking. Tobacco byproducts irritates the tonsils.
  • Chronic infection of the tonsils or secondary spread from neigboring regions (ear, mouth)
  • Peritonsillar abscess that pushes the tonsils out towards the uvula. This does not cause an enlarged tonsil but may appear as an enlarged tonsil. This is usually acute.

Symptoms of Swollen Tools

  • Tenderness or pain in the region of the throat.
  • Snoring due to tonsils causing airway obstruction.
  • Recurrent ENT infections and aggravations like sinusitis, rhinitis and otitis.
  • Poor mental development in children due to reduced air intake in severe cases.
  • Halitosis (bad breath)

Diagnosis

If you are coughing up speckles of food, consult with your family doctor who may refer you to an ENT (ear-nose-throat) specialist (otolaryngologist). It is advisable to seek medical attention for repeated infections as well as it can quickly lead to complications due to the sensitive nature of the region.

Treatment & Management

  • A tonsillectomy is often required in these cases to prevent further aggravation of the condition or complications.
  • Antibiotics will be necessary in acute tonsillitis or any infection in the surrounding region.
  • An antimicrobial mouth wash may be advisable to reduce the chances of infection.
  • Good dental hygiene is important to prevent secondary spreas of infection between the tonsils and teeth.

Naturopathic & Homeopathic Treatment :

It is advisable to consult with your ENT specialist before considering any alternative therapies.

  • The homeopathic remedy Lachesis muta 6CH to 30CH may be useful for recurrent sore throats.
  • Echinacea angustifolia or Echinacea purpurea used on a regular basis may assist with preventing infections.
  • A herbal mouth wash containing remedies like Marshmallow, Echinacea, Coltsfoot and Golden Rod may be useful.
  • A simple salt water solution may also be a suitabel mouth wash to reduce infections and soothe the tonsils.