Coughing uses muscles that also play a role in vomiting, which is why people sometimes throw up after coughing.

When people cough, the aim is for air to force irritants and mucus out of the throat to prevent choking or infection.

Sometimes, a cough is very forceful and loud. While most coughing is not serious, a strong cough can break bones, cause bleeding, or make someone vomit.

People can vomit after coughing hard because the muscles that the cough triggers are also responsible for vomiting. It is not usually something to be overly concerned about.

This article evaluates why someone might cough so hard that they vomit, the treatment options, and when to contact a doctor.

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Potential causes for coughing that leads to vomiting include respiratory conditions, such as asthma and COPD. Image credit: Kzenon/Shutterstock

There are various reasons why someone might cough so hard that they vomit. These include:

  • smoking
  • asthma
  • COPD
  • infection

Cigarette smoking

Inhaling smoke can cause significant irritation to the body.

The various components of cigarette smoke can damage the protective elements of the airways in the lungs. This damage means that the body cannot properly clear mucus, germs, and foreign particles from the airways.

For this reason, many people who smoke have chronic coughs lasting many weeks or months.

This cough can be dry or productive, meaning that it brings up phlegm. Sometimes, it can be so severe that it causes vomiting.

Chronic obstructive pulmonary disorder (COPD)

COPD is a chronic obstructive lung condition that is common in people who regularly smoke.

This condition causes the lungs and airways to become so severely inflamed that air does not easily pass through. A chronic and severe cough is one of the symptoms of COPD.

Read about the early signs of COPD.

Asthma

Asthma is a condition featuring a chronic cough that is the result of inflammation in the lungs. The airways react to an allergen or irritant by narrowing, which triggers coughing.

A chronic cough is sometimes the only sign of asthma. However, some people experience wheezing, difficulty breathing, and excessive mucus.

Cough variant asthma is a type of asthma where the only symptom is a chronic, dry cough, which can be severe enough to cause vomiting.

Infection

Several different types of infection can cause a severe cough, including the following:

A severe infection known as respiratory syncytial virus (RSV) can cause bronchiolitis and pneumonia in infants.

All of the above infections can increase the production of mucus in the airways, which triggers coughing. Gagging and vomiting can result from severe coughing in these cases, too.

Gastroesophageal reflux disease (GERD) or acid reflux

GERD and acid reflux result from stomach acid backing up into the food pipe and sometimes into the airways.

This can irritate the throat and cause coughing, which in some cases can be severe.

Learn more about GERD and acid reflux.

Some blood pressure medicines

A type of blood pressure medication known as angiotensin-converting enzyme (ACE) inhibitors can cause severe coughing in some people who take them.

Learn more about ACE inhibitors.

Paroxysmal coughing is a term healthcare professionals use to describe violent and uncontrollable coughing attacks, which may also have gagging or vomiting accompanying them.

This often occurs during the second stage of whooping cough, a bacterial infection that can be especially serious for infants under the age of 1.

Other conditions may also cause it, including:

If a person experiences sudden coughing fits that become increasingly severe or last longer than a week, it is best for them to talk with a healthcare professional to determine the cause and the best course of treatment.

A person should seek immediate medical attention if they experience any of the following symptoms:

  • difficulty breathing
  • chest pain
  • chills
  • fever
  • bluish discoloration of the lips, tongue, or skin
  • loss of consciousness

Diagnosing a chronic cough generally starts with a thorough medical history and physical exam. A healthcare professional will ask about symptoms and things that trigger or relieve the cough.

During the physical exam, they will use a stethoscope to listen to the chest. The healthcare professional can tell whether fluid is in the lungs or if an airway obstruction is present on the basis of the sounds that a person produces when they breathe.

They may request additional tests depending on the results of the medical history and physical examination. These tests can include:

A single episode of coughing so hard that a person vomits is not typically a reason to contact a healthcare professional. However, people should seek medical help if they have a chronic or severe cough that does not improve within 3 weeks.

People should also call a doctor if they have any of the following additional symptoms:

A person needs prompt treatment if any of these symptoms are present.

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A person can do several things at home to treat a cough before contacting a healthcare professional. The remedies depend on the cause of the cough.

If a cough occurs after eating, such as with GERD or acid reflux, people can try using an antireflux medication, such as TUMS.

Heartburn that is so severe that it causes a cough that medication cannot relieve requires evaluation by a healthcare professional.

For people who have a long-term cough due to smoking, quitting smoking can help. Smoking can both cause and worsen a severe cough. Furthermore, it can lead to serious health problems that provoke further coughing.

People who smoke can ask a healthcare professional for help to quit or check out www.smokefree.gov for additional resources.

If an infection causes the cough, these home care measures may help:

  • drinking extra fluids
  • resting
  • avoiding exercise temporarily
  • using over-the-counter cough suppressants
  • trying a chest rub such as VICKS
  • taking honey or sipping warm fluids

People should check with a healthcare professional if home care measures do not help a cough within 3 weeks or if it worsens.

Learn more about home remedies for cough.

Treatment for coughing so hard that a person vomits involves managing the underlying condition that is causing the cough.

If home remedies do not help, treatment options may include:

People should be sure to follow up with a healthcare professional if the prescribed medication does not relieve the cough.

The outlook is good for a person who experiences coughing that causes vomiting. In most cases, such a severe cough is a short-lived condition that will go away once the person receives treatment for the cause.

However, there are some serious conditions that may be behind a strong cough, and these will require ongoing care from a healthcare professional.

It is important for people to follow up with a healthcare professional if a severe cough does not go away or improve so that they can receive the correct treatment.