Hyperactive Gag Reflex

Hyperactive Gag Reflex: Definition, Description, Causes and Risk Factors:

Hyperactive gag reflex is the body's response to the stimulation of soft palate or posterior pharynx. Every one has a gag, but it becomes a problem when an individual finds it difficult to eat certain foods or perform certain activity. It is a very common feeding disorder among children. If your baby throws up and chokes herself every time you try to feed her with certain foods, it could be due to hyperactive gag reflex. Children with this disorder simply refuse to take solid foods or foods with particular texture. This makes it impossible to feed them.hyperactive gag reflex medigoo

Before getting to gag reflex causes, let us first get to the mechanism behind this awful feeling of throwing up whenever you stick something in your mouth that goes far towards the back of your throat and touches the soft palate. The irritation caused to the pharynx by such an activity always, without fail, evokes a disgusting feeling as if you're going to throw up. There are different levels of sensitivity among different people with regards to causes and extent of gag reflex. Gagging is a natural phenomenon which is meant to prevent anything, which is not part of the natural eating and swallowing process, from entering the throat in order to keep the person from choking by obstruction of the respiratory tract, the upper part of which is connected to the upper part of the digestive tract. However, sometimes gagging is artificially induced by sticking one's finger inside the mouth, far down the throat, to orally expel food that was recently eaten. This method is widely used by bulimics, victims of a kind of eating disorder, who frequently induce vomiting this way soon after eating something.

Whenever something that is not part of the natural swallowing process enters the throat so far as to touch the soft palate, the back of the throat contracts and we get a feeling that we are about to vomit. The glossopharyngeal nerve fibers, which pass from behind the nasal cavity, pick up the sensation whenever an unnaturally large amount of food is swallowed or something other than food is attempted to be pushed down the throat. These nerve fibers transmit the gag sensations to the solitary tract and spinal trigeminal nuclei. Finally, these signals reach the brain which sends back instructions, in the form of electric pulses and chemical signals, back to the pharyngeal nerves to contract and cause such invasive objects to be expelled.

There are no particular causes of hyperactive gag reflex as such. It's just an aversion to certain textures of food that induces a severe urge to gag. Certain activities that need you to open your mouth for a long time or putting something in the mouth can also result in a gag. Basically, anything that brushes against the soft palate and stimulates it, results in a gag. Adults may experience it while getting a dental job done, which requires the person to keep his mouth open for a very long time. Moreover, during a dental job, certain instruments or solutions stimulate the soft palate and aggravate the feeling to gag.

Symptoms:

Hyperactive gag reflex is characterized by high sensitivity levels in the pharyngeal nerves and surrounding area of certain individuals which leads to evocation of gag reflex at the slightest instance. This overactivity of the gag reflex is generally experienced by infants who are often not able to swallow their food properly and tend to throw up much of it. Overactive gag reflex causes in adults, though rare, may include sensitivity to certain foods, reactions to some sort of medication, indulging in activities that involve high intensity movements such as swimming, running, etc. Hyperactive gag reflex often include dental treatment sessions and indulging in prolonged periods of excessive laughter.

Diagnosis:

The gag reflex is elicited by touching the posterior pharyngeal wall, tonsillar area, or the base of the tongue, with the tip of a thin wooden ("orange") stick; depressing the tongue with a wooden spatula, and the use of a torch for illumination of the posterior pharynx, may be required to get a good view. There is a palatal response (palatal reflex), consisting of upward movement of the soft palate with ipsilateral deviation of the uvula; and a pharyngeal response (pharyngeal reflex or gag reflex) consisting of visible contraction of the pharyngeal wall. Lesser response include medical movement, tensing, or corrugation of the pharyngeal wall. In addition there may be a head withdrawal, eye watering, coughing, and retching. Hence there is a variability of response in different individuals. Some studies claim the reflex is absent in many normal individuals especially with increasing age, without evident functional impairment; whereas others find it in all healthy individuals, although variable stimulus intensity is require to elicit it.

The afferent limb of the reflex area is the glossopharyngeal nerve, the efferent limb in the glossopharyngeal and vagus nerve. Hence individual or combined lesions of the glossopharyngeal and vagus nerves depress the gag reflex, as in neurogenic bulbar palsy.

Dysphagia is common after a stroke, and the gag reflex is often performed to assess the integrity of swallowing. Some argue that absence of the reflex, since it may be normal in elderly individuals, does not predict aspiration and is of little diagnostic value, whereas pharyngeal sensation (feeling the stimulus at the back of the pharynx) is rarely absent in normals and is a better predictor of the absence of aspiration. Other find that even a brisk pharyngeal response in motor neurone disease may be assoicated with impaired swallowing. Hence the value of the gag reflex remains debatable. A videoswallow may be a better technique to assess the integrity of swallowing.

Hyperactive Gag Reflex Treatment:

It is possible to get rid of your hyperactive gag reflex through desensitization, which means training your soft palate to receive objects without gagging. The best time to train your soft palate is when you're brushing your teeth. Do the following steps while you're brushing, and get rid of your gag reflex as soon as possible.

Find out where the gag reflex starts. Use the toothbrush to brush your tongue. Start from the farthest tip of your tongue, then work your way in deeper.

  • Once you begin to gag, try to brush that area for about 10 seconds even while you're gagging. This process is quite unpleasant, but training yourself not to gag naturally involves some gagging. Stop brushing when you feel like you can't continue any longer; training yourself can't be done in a day.
  • Repeat the process over the next few days, concentrating on the exact same spot. You'll notice that you gag less each time you repeat it. Stay on the same spot until you can handle most of the gagging or gagging completely stops. That part of your mouth is now desensitized.
  • Reach deeper into your mouth using the toothbrush. Try brushing half an inch behind the desensitized spot. Keep moving further back until you've reached the farthest area that the brush can reach.

The whole desensitization process should take about a month to complete, so don't lose hope if nothing improves in the first couple of days. When desensitization is complete, your doctor can swab the back of your throat all he wants, and you won't gag at all. Remember to repeat the process from time to time because your gag reflex may return if you don't.

Don't start too far back because you'll only gag pointlessly. This process only works if you do it one tiny step at a time.

  • It's not advisable to do this twice a day because if you vomit your food, then your body won't be able to digest the nutrients it needs. Do it once either in the morning or before you go to sleep in the evening.
  • Don't breathe through your mouth while you're brushing; instead, breathe through your nose to avoid triggering the gag reflex.
  • You may want to talk to your doctor first before desensitizing your soft palate. This training is also not recommended for children, as they might choke on the toothbrush.

NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

53 Comments

  1. Rajender Simar

    Hi,

    I am facing same problem when brushing inside part of teeth or drinking water a bit more or sometimes during smoke.It is regular that when i brush my teeth inside part, there is instant vomit. Will try above procedure from tomorrow when going to brush. thanks for your valuable post.

    Reply
    • editor-m

      Thank you for commenting, looking forward to hear feedback about the procedure effect.

      Reply
    • Lenora

      I have experienced a gradual increase in gag reflex sensitization / intensity over the past 5-6 months. However, this morning, it made a quantum leap to full on vomiting – three times. This occurred while brushing the middle to back areas of my tongue and thereafter while swishing water around in the same areas to rinse toothpaste and excess saliva from my mouth. I do not know what is causing this to worsen. I have fairly severe GERD for which I have been treated with Protonix for almost 20 years and in 2015 I was diagnosed with a hiatal hernia. I decided to research the problem and to look for possible solutions. I am grateful to find this post and will get started tonight. Thank you.

      Reply
      • marko r

        Thank you for your comment.

        Reply
    • abhinandan

      J have same problem since long.arround since 5 years.This problem is so weird and embarrassing.becoz of this,i stopped going out with friends as i may puke even while eating some food.I want to discuss problem with other people who experience same.

      Reply
  2. Shahla

    My toddler (23 months old) has been gagging before nursing and bottle feeding since birth. He refuses to open his mouth to allow a spoon to enter. I weaned him from nursing 2 months ago. Currently his only nutrition comes from toddler soy formula (he has a milk protein allergy). He has been getting feeding therapy for 2 months but hasn’t improved. Could you please give me suggestions on how to help somebody his age? Thank you so much.

    Reply
    • editor-m

      Thank you for your comment, Shahla. You should definetly talk about possible treatment options with your pediatrician because it’s not possible to advise without physical examination.
      Take care!

      Reply
      • sue

        If you haven’t already checked into the child being “tongue tied” check it out with your pediatrician. My nephew had it where he couldn’t eat so many things but after the diagnosis and treatment he is much better.

        Reply
  3. Hugh Sullivan

    I 74 years old and never had a gaging problem. Now almost every time I eat I experience the problem. Frequently I throw up any thing that I have eaten. I will try your desensitize process with my toothbrush.

    Reply
    • editor-m

      Thank you for sharing your problem. Hope that the treatment will help you.

      Reply
  4. Nour

    Hello Im 18 years old. Lately my gag reflex acts up everytime I eat honey, chinese food or take in antibiotic pills. What could be the issue how can I solve it

    Reply
    • editor-m

      Thanks for commenting. You may try some treatment option from this article.

      Reply
      • Laura Stafford

        Could it be possible to have a more intense gagging reflex due to seasonal allergies?

        Reply
        • marko r

          Yes, the seasonal allergies may trigger the gagging reflex.

          Reply
  5. Yon Yonson

    Is there not medication for this condition? I’ve had this for ten years now but the thought of slowly trying to desensitise my reflex frightens me, and I long endlessly for the day when I’m free from this wretched illness. I wouldn’t have the gumption to even try this procedure once.

    Reply
    • editor-m

      Firstly, you should clarify the cause of gagging and then maybe try to avoid it by using some medication if possible. For this contact your doctor and get professional help.

      Reply
  6. Sherry

    I have had this problem for a few years. It is worse in the mornings. I gag every time I brush my teeth. Also if I bend over (let’s say to pick up something) I start gagging. But all through the day certain smells or certain food will cause it too. And sometimes it causes me to vomit. Should I be concerned?

    Reply
    • editor-m

      Yes, the symptoms you described could be a sign that you need to start treatment. Please, discuss possible variants with your doctor.

      Reply
  7. Travis Davis

    What about when so much as a shirt touching your throat barely causing you to gag? I look like an idiot in public adjusting my shirt to keep from gagging every 5 minutes.

    Reply
    • Susan Taylor

      Hi Travis. I am SO grateful that you posted this, although I am sorry for your suffering. I am 56 years young, and I too have had this gag reflex problem so severely, that merely the brush of a shirt collar or the touch of a necklace around my neck can instantly trigger such a tremendous reaction that I have literally yanked the necklace off my neck. I can’t even have the hair stylist put the cape around me or I will gag incessantly. So far I have never actually vomited, but I have had some terrible dry heaves. I am fairly convinced that this is related to an early childhood trauma that I experienced, but have not yet figured out a way to cure it. I have had it since I was about 15 years old. It definitely interferes with many aspects of my life. I am considering hypnosis; the desensitization thing is out of the question! I would probably die of terror.
      Any comments from anyone who has tried hypnosis or any other method (other than desensitization…yuck!)would be eternally appreciated. God bless all you fellow sufferers. My heart goes out to you. (and possibly my tongue, too!!!)

      Reply
      • Tara Knable

        I gag from so many things…necklaces, shirt collar, my own hair. Seriously, I have short hair because i gag from hair touching my neck. As far as I know I have no trauma that caused this. If anything gets close to my neck, i gag. I need this to stop, it is interfering with my life. Desensitizing might help the inside of my mouth but what about my neck? If anyone has a solution, please help.

        Reply
        • Patrick

          I can’t wear neck ties anymore because of this gag reflex issue I have. This is not good because the last time I needed to wear a tie was for a job interview. I forced myself to where one and when I was just a mile away from my destination on a freeway off ramp, I started gagging while I was driving. I had to pull over to the side of the lane to rip my tie off and open the car door to prevent from vomiting inside. That scared the hell out of me.

          This issue also makes me avoid certain foods; pretty much all raw fruits and vegetables. Even some canned veggies like Beets. I also avoid things like Cole-slaw, cottage cheese and certain kinds of dishes that have vegetables cooked in. Sometimes I can get a bit or two (forced) down but beyond that…..

          I’ve asked a doctor about this and was told that it’s called “post nasal drip – due to allergies”.

          Reply
  8. Jennifer

    My gagging has gotten worse over the past few months. I will gag about 6 times each time and about 15 times a day. If I think about something unpleasant, certain smells, if its too muggy, if I bend over, just sitting watching TV, smoke, ect. It doesn’t happen every time I do these actions and never with eating or drinking It does happen very first thing in morning and if my shirt or jacket get too close to my neck. Liquid helps. No other symptoms of acid, mucus, soreness or pain. Getting increasing worse to almost vomiting now. What could be causing it?

    Reply
    • The lel

      same here for me i gag because of certain smells from certain foods have you figured out anything to solve it? Mine is getting worse too

      Reply
    • Mary

      This is also the same with me. I am 39, I thought it was related to my getting older but it’s truthfully scaring me a little, but I feel silly going to a dr for it. I can be talking and just start gagging, I can’t take my vitamins any longer since I literally start gagging to the point of vomiting every time I try to swallow them. I gag for no reason as all, if I grab a drink real fast or something hard like a mint or chewing gum I can get it to stop for a min but then half the time whatever I have used to stop it then starts causing me to gag again. It’s a terrible cycle and so embarrassing. I would love if anyone had any ideas as to why this has happened and what to do. I will try the toothbrush idea as that has become an awful experience also, but I don’t see how it will help all the times it happens without my even having anything in my mouth.

      Reply
  9. Phillip

    I have also had this problem for years. I believe its a psychological problem. Is there anxiety medication that i could take for it.

    Reply
    • john hoggett

      most anxiety medication is addictive so even if it works it could lead to worse problems. Non drug based treatments are either talking things over, learning to relax, meditation or behavioural treatments as descirbed in the article.

      Reply
      • laura Davies

        That’s not necessarily true. Anti depressants and antipsychotic medication are used for longer term anxiety and are not addictive. Only things like the pams ie diazapam or lorazepam can be addictive and are no longer recommend except in exceptional circumstances for very short term therapy ie days tp a cpuple of weeks. Normally in the UK thos is prescribed through a psychiatrist. Talking therapies will be helpful in getting to the root cause and put in place coping mechanisms. Relaxation and a work/life balance are also useful. Its important not to discourage others from seeking treatments and keep an open mind. What is addictive or unsuccessful for one may not be for another. It is best to talk this through with a Dr to rule out other causes first and then discuss your options. They will see several people every day with anxiety, its very common.

        Reply
    • Kelly Frost

      Phillip, I am sure mine is psychological as well. Anytime I am trying to get out of the house or bend over I gag. I gag just thinking about gaging. I am already on anxiety meds, but it just isn’t working; I am researching and this feed came up. Have you found anything?

      Reply
    • Jimmy

      I have had this problem since my teenage years: t-shirt or necklace around my neck, heavy breathing when exercising, etc. Wearing a tie was out of the question. I believe this was triggered by a severe psychological trauma I experience at the time. The worse was going to the dentist. anything touching my tongue further back than halfway would trigger gagging, dry heaves and in some cases, vomiting. I was kicked out by a few unfriendly dentists who refused to put up with it. To make matters worse, I don’t have good teeth.
      It has gotten better over the years with some therapy and relaxation techniques but going to the dentist is still a problem. Although I have found a few friendly dentists who would be patient enough, I have to be sedated for complex procedures like a root canal. The problem is sedation is expensive.
      Curious to hear if other people have had similar challenges with dental procedures.

      Reply
      • Mustafa Alsaaidy

        Dude that excactly what hsppens to me iwas taking off my wisdom tooth and when he injected me with the needle ileft my chair and vomited in the trash can but the big problem is when he took my tooth off because he was nervuse he dropped my teeth in my mouth and i almost choked out uwas out of breath or ieas gonna swsllow my ripped toooth worst experience in my life, big problem i neeed to take off my other wisdom tooth now donno what to do but its hurting me 🙁 , i dont gag to any tupe of food, any other object enters my mouth the gag is triggered , even when i smoke sometimed it is triggered somtimes not itz weird ,i i,m 100% sure its psychological problem

        Reply
  10. donna

    My son is autistic and is 15 years old. He still eat baby food for lunch and dinner. He only eats about 6 things. The last 6 months he has been gagging and throwing up any soft foods after only a few spoonfuls. Doctors cannot diagnose what is wrong with him.

    Reply
    • Lauren

      I work with two autistic teenagers at work. They both gag often when eating, especially the male. He will gag with food but also when anxious or not getting his way.

      Reply
  11. Susanne

    I have had both my tonsils and adenoids removed when I was 4. I must pass a fit test for my job. I gag horribly during testing when a breath tube is inserted while I run. Will the procedure you mentioned about desensitizing the palate help to pass or can you suggest anything else. I will have to do this fit test within the next 2-3 weeks.
    Thank you

    Reply
    • maisteri

      You can try the desensitizing of the palate. In case it doesn’t help you may use over-the-counter throat-numbing spray (Chloraseptic) or topical over-the-counter analgetics (Lidocaine) to desensitize the palate before the testing. However, make sure you are not allergic to the medication and consult with your GP if you consider to use the drug to decrease the gag reflex.

      Reply
  12. Duncan H

    Ever since I got my braces off my gag reflex has been very touchy, talking loudly or getting in stressful situations makes me gag regularly. I’ll be trying this, but is there anything else I can try to help train my gag reflex to relax while talking loudly or yelling? Also for other commenters asking about medication Zofran/Odansetron is a good temporary fix.

    Reply
    • maisteri

      Unfortunately, there is no other way to train your gag reflex, though you may try to trick your body by squeezing your thumb in a fist while talking loudly or yelling.

      Reply
  13. Lynn

    I am suddenly experiencing a strong gag reflex. I vomited after brushing my teeth recently and I have had heaving episodes a few times. This occurs after disgust rather than something touching my throat except in the case of brushing my teeth. There was a hair on my plate that made me gag and heave. I thought I was going to vomit but didn’t. Then it happened later that day with a hair in my food and I gagged. What rotten luck, right? But I have also gagged over dirty public bathrooms recently. So, it’s not just touch for me but as I said more disgust. Any thoughts?

    Reply
    • maisteri

      It is not so common for the gag reflex to occur so acutely and the feeling of disgust usually do not cause gagging rather vomiting as your body tries to protect itself. Maybe you should look for some other possible reasons for this condition like any disorders of gastrointestinal system.

      Reply
  14. JAKE

    I am 91. I have COPD and have chest infections causing coughing ans green sputum ,I have no infection now but have violent coughing spasms usually a short while after eating or lying down. I have always had a strong gagging reflex and guessed that small particles of food stuck between teeth maybe the cause so now I brush my teeth after eating and mouthwash to be sure no partcles remain and it seems to be working.An ENT specialist has used an scope and found no lesions.I am due for a barium meal test so

    Reply
  15. Hadeel

    My husband is now 57 years old. He hasn’t been able to eat beef, lamb, fish, or any other protein unless ground. Now he stopped eating even ground meat.
    He has a gag reflex every time he tries to eat meat. He stopped trying. Will this toothbrush practice help him?

    Reply
    • maisteri

      Your husband may try toothbrush practice, although it’s unlikely that it’ll help.

      Reply
  16. Hadeel

    Since my husband was a little boy, as young as two years old, he wouldn’t eat protein (lamb, beef, chicken, sea food). He eats eggs as long as the whites is not showing. I have to mix the eggs very well and add curcumin to make the whole egg look yellow in color. I have to remove the tiny little white bits in the egg-white that is gelatinous and doesn’t mix with the yolk, coz after cooking these bits show as white and if he sees these little white pieces he stops eating. When we first got married he used to eat burgers or ground protein. So I used to make fish cakes and burgers. Now even those he can’t eat. He is now 57 years old. Is there a way to know if it is a gag reflex, a chewing problem, or a psychological problem? The moment the protein piece is inside his mouth and he starts chewing the gag reflex starts.

    Reply
    • maisteri

      There is no other way to verify the reason for your husband’s condition other than visiting your GP. He will order all the necessary tests or recommend you to visit psychotherapist if needed. However, the possible underlying condition of this problem may be a stomach disorder or enzyme insufficiency.

      Reply
  17. Franklin Egnew

    Ever since I was 12 I gag and/or throw up when I see or have to deal with a dead bug. Is this normal or something I should be concerned with?

    Reply
    • maisteri

      It’s rather a natural reaction to smth disgusting than a thing you should be concerned about.

      Reply
  18. Becky Bunny

    I outgrew my oversensitive gag reflex by my teens. Unfortunately it came back after getting my tonsils out when I was 27. I wish amongst other reasons that I never got them out. I gag when I get a tongue depressor or throat swabbing. I haven’t been to dentists for routing cleaning since 1989 cuz I couldn’t afford it. Lately my insurance can cover 3000 a year & vie needed root canals & fillings. I used throat spray to suppress the reflex after coughing & gagging at the same time. I used laughing gass once but not sure if it made me ill for a week. Ill try this technique & hope it helps as my root canal isn’t finished yet. Thank you.

    Reply
  19. Tommy R HUNTINGTON

    Would botox help gag reflex symptoms?

    Reply
    • maisteri

      Botox is sometimes injected to relieve gag reflex, although several injections may be needed. However, the effectiveness and outcomes of such treatment remain unknown, as there were no clinical trials for botox therapy.

      Reply
  20. Veronica Yee

    I’m 54 years old my name is Veronica I have a severe gag reflex it happens it happens at anytime it never happens when I’m eating I don’t know what to do and what it could be related to it’s been going on for about a month sometimes it happens when I’m brushing my teeth most of the time it doesn’t it can happen any which way and I can go on from 3 to 5 minutes

    Reply
    • maisteri

      Consult with your GP regarding these symptoms as further examination is necessary to verify the cause of this disorder.

      Reply
  21. Yasar m

    My 4 year old son has been gagging and throwing up since he was 8 months old. We’re planning a trip to the doctor again, well a different one to see what they say. what could it be? Other than being a picky eater and always saying no to 95% of foods he is health. Doctors never ordered a blood test.

    Reply
    • maisteri

      The symptoms you describe may be related to the enzyme deficiencies (for example, lactose deficiency or celiac disease) or inborn abnormalities of the gastrointestinal tract, although in this case your son would’ve been malnourished and weaken. Nevertheless, consult with your GP and have a blood test done to make sure that your son is not suffering from any essential nutrients deficiencies due to his picky eating.

      Reply

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