Why Do I Experience Shortness of Breath After Eating?

Shortness of breath after eating may be related to a respiratory condition like asthma or chronic obstructive pulmonary disease (COPD), or a digestive problem like hiatal hernia and gastroesophageal reflux disease (GERD). It might also be a symptom of a severe food allergy (anaphylaxis) or a sign that you accidentally inhaled food (pulmonary aspiration).

Shortness of breath, or dyspnea, can feel like a tightness in your chest or give you the sense that you are suffocating. It may be a sign of a treatable condition like heartburn or a sign of a potentially life-threatening medical emergency.

This article describes common causes of shortness of breath after eating. It will also help you recognize when your symptoms require immediate medical attention.

Anaphylaxis

Anaphylaxis is a severe allergic reaction that affects the entire body. Shortness of breath after eating can be the first sign, often occurring within minutes or hours of eating something you're allergic to (known as an allergen).

The nine most common food allergens include:

• Milk
• Eggs
• Fish 
• Shellfish
• Tree nuts (such as almonds or walnuts)
• Peanuts
• Wheat
• Soybeans
• Sesame

Anaphylaxis is treated with a shot of epinephrine (adrenaline) which causes blood vessels to narrow, preventing dangerous drops in blood pressure that can lead to shock. It also reduces swelling of the upper airways (laryngeal edema), restoring normal breathing.

Identifying and avoiding your food allergens are key to prevention. Allergy testing by an allergist can help identify the allergen so that you can get allergy shots. Allergy shots expose you to tiny amounts of an allergen so that your sensitivity to it can be gradually decreased.

Heartburn

People with heartburn may feel shortness of breath or start to wheeze during or after a meal. This is caused by acid reflux, a condition in which stomach acid moves back up into the esophagus (feeding tube) The harsh burning sensation in the chest may be accompanied by wheezing or shortness of breath.

A main cause of heartburn is weakness in the lower esophageal sphincter (LES). This group of muscles acts as a valve between the stomach and the esophagus. If the LES isn't working right, stomach acid can move in the wrong direction.

Gastroesophageal reflux disease (GERD) is a chronic condition in which you experience acid reflux frequently. People with GERD often feel as if they have something stuck in their throat. In addition to shortness of breath, there may also be coughing, hoarseness, or hiccups.

Some lifestyle changes can help reduce your heartburn. They include losing weight, avoiding alcohol, and not smoking. You also may want to limit your exposure to foods that can lead to heartburn, such as fried or spicy foods.

Over-the-counter medications can also ease stomach acid production, such as Pepcid AC (famotidine) or Prilosec (omeprazole).

COPD

Chronic obstructive pulmonary disease (COPD) is a progressive and irreversible disease of the lungs that causes hardening and widening of the airways and the overproduction of mucus. Smoking, or exposure to secondhand smoke, is a major cause.

Over time, the damage caused by COPD makes it harder for air to flow in and out of the lungs. Limited airflow makes it harder to breathe and can lead to chronic cough and chest tightness.

People with COPD may feel short of breath after eating because large meals take up significant space in the chest and stomach area. This can place pressure on the lungs and restrict the movement of the diaphragm (the muscle situated between the abdominal and chest cavities that aid with breathing).

Large meals also take more energy to digest, which can compound COPD-related fatigue. Eating smaller meals several times a day can help alleviate this. So can eating less salt, which causes fluid retention throughout the body and can make breathing harder.

If you have COPD and you are using supplemental oxygen, be sure to use it while eating too.

Asthma

Asthma is an obstructive lung condition similar to COPD which causes the narrowing of airways and the overproduction of mucus in the lungs. Shortness of breath and wheezing are hallmark symptoms along with chest pain and cough.

Asthma may occur after eating if you have a food allergy (allergic asthma). GERD is also known to trigger asthma in some people as stomach acid leaks into the esophagus.

Asthma can be triggered by many other things, including dust mites, pet dander, mold, pollen, air pollution, emotional stress, aspirin, respiratory infections, extreme exercise, and very cold air.

There is no cure for asthma, but you can reduce your risk of an attack by knowing your triggers and avoiding them. If you have GERD, it also helps to avoid reclining after meals to reduce the backflow of stomach acid into the esophagus.

Asthma attacks can be relieved with rescue inhalers like albuterol and consistently controlled with inhaled, oral, or injected medications like corticosteroids (steroids), long-acting bronchodilators (LABAs), mast cell stabilizers like cromolyn, and biologic drugs like Fasenrah (benralizumab).

Hiatal Hernia

A hiatal hernia is a condition in which part of the stomach pushes up through a weakness in your diaphragm. This can alter the position of the LES and enable the backflow of stomach acid into the esophagus. This can lead to heartburn and chest pain as well as shortness of breath and coughing.

There are many possible causes of hiatal hernia, including older age, obesity, and smoking. Losing weight and quitting cigarettes can significantly reduce symptoms.

Surgery is sometimes recommended to repair a hiatal hernia in order to prevent acid reflux. However, certain types of hiatal hernia, such as paraesophageal hernia, are less responsive to surgery and likely to ease respiratory symptoms.

Pulmonary Aspiration

You can become short of breath during or immediately after accidentally inhaling food or drink. This is called pulmonary aspiration. It means that food, drinks, or saliva have gone into the trachea (windpipe) or lung instead of into the esophagus and stomach.

Pulmonary aspiration can trigger immediate symptoms such as coughing, choking, shortness of breath, wheezing, and a feeling that something is lodged in the chest. With that said, some people may not be entirely aware of the event if they are asleep or intoxicated.

Accidental aspiration can happen to anyone, but certain conditions or situations can increase the risk, including:

• Vomiting, in which the violent contractions can open the muscular valve that would otherwise keep the trachea shut
• Stroke, which can weaken muscles and reflexes associated with swallowing and coughing
• Other neurological disorders, like Alzheimer's disease and Parkinson's disease
• Achalasia, a rare disorder that makes it difficult to pass food or liquid into the stomach
• GERD, in which regurgitated stomach acid can be passed to the stomach, often while asleep
• Epilepsy, in which seizures can cause vomiting and aspiration
• Alcohol and sedatives, which can disable the gag reflex and alter your state of consciousness
• General anesthesia, which can temporarily paralyze the gag reflex
• Obesity, which can alter the position of the trachea and esophagus

In some cases, people can develop aspiration pneumonia when an inhaled substance causes an infection in the airways of the lungs. Antibiotics, or even hospitalization and breathing assistance, may be needed.

When to Get Medical Attention

Trouble breathing, for any reason, is a serious medical concern.

If you have shortness of breath after eating and you have a known food allergy, use your Epi-Pen or other medication and call 911. You may be having a life-threatening anaphylactic reaction.

Other health problems, such as COPD or GERD, may contribute to trouble breathing at mealtime. See your healthcare provider to find out why you are having these issues and how to treat them.

If you're already having treatment for a condition known to cause breathing difficulties, but you still experience shortness of breath after eating, still see your provider. You may need a change in your treatment plan or additional lifestyle modifications.

Summary

Shortness of breath after eating can be related to respiratory problems, like asthma and COPD. Additionally, conditions that affect the digestive tract—including GERD and hiatal hernia—can lead to shortness of breath after eating. A severe food allergy reaction, which is a medical emergency, can also be the cause.

If eating affects your breathing, talk to your healthcare provider so you can get a proper diagnosis. Most conditions that cause shortness of breath have a better prognosis when treated early on.