What Happens When Food Goes Down the Wrong Pipe?

Ever coughed and sputtered when water or food unexpectedly goes down the wrong way? It's a common experience, but what exactly is "the wrong hole," how dangerous can it be, and what are the strangest possible outcomes?

The Anatomy of Swallowing

Swallowing seems simple: chew, move food down your throat, and into your stomach. However, it's more complex. When you put food in your mouth, over 30 muscles work together to break it down. Your tongue pushes the food down your throat, where the passage splits into two pipes:

• Esophagus: The food pipe leads to the stomach.
• Trachea: The windpipe leads to the lungs.

Ideally, food should go down the esophagus. But even when it does, you might experience an irritating feeling of fullness in your upper chest.

When Things Go Wrong: Aspiration

So, what causes that frantic coughing and choking when something "goes down the wrong hole?" It happens when food enters the trachea instead of the esophagus. To prevent this, the larynx (voice box) has a flap called the epiglottis. This blocks the trachea when we swallow, ensuring food takes the correct path.

However, the epiglottis isn't foolproof. When distracted or not fully conscious, the brain may struggle to position everything correctly. This leads to aspiration, where food or drink enters the windpipe.

The Body's Response

As Dr. Clark Rosen explains, when something goes down the wrong way, you feel like you can't breathe, and your voice is constricted. This is because the body enters "restriction shutdown violation mode." The epiglottis quickly shuts off the windpipe to prevent further entry of food or drink.

If food manages to sneak into the trachea, the body initiates gag and coughing reflexes. This clears the material out of the trachea and into the esophagus. Once the airway is clear, breathing and speech return to normal.

The Dangers of Aspiration Pneumonia

Sometimes, coughing isn't enough to dislodge the food. The troublesome morsel travels down the trachea and into the lungs. A lung full of food or drink isn't ideal and can lead to a chest infection called aspiration pneumonia.

Symptoms of aspiration pneumonia include:

• Chest pain
• Dry or phlegmy cough
• Difficulty breathing
• Temperature of 100°F (38°C) or higher

While antibiotics can treat the infection, aspiration pneumonia can be fatal. A 2013 study in the Journal of Hospital Medicine found that 21% of 628 patients with aspiration pneumonia died within 30 days. The average age of these patients was 77, as muscles react slower and sensation decreases with age, making aspiration more common.

The Case of the Sprouting Pea

In rare cases, something truly bizarre can happen. The lung's warm, moist environment can be fertile ground for seeds. If you inhale a seed and don't cough it out, it can theoretically sprout in your lung.

In 2010, 75-year-old Ron Sveden was admitted to the hospital with breathing difficulties and a severely infected lung. Surgeons discovered a 1.25-centimeter pea seedling growing inside. Fortunately, they removed the seedling, and Ron recovered.

The Takeaway

Whether you're eating popcorn or peas, never stifle a cough when something goes down the wrong way. Clear your airway to move the food from the wrong hole to the right one, fast!