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What’s to know about coughing so hard you vomit?

A cough is the body’s response to the presence of something irritating in the throat or the airway. The purpose of a cough is for air to force the irritant out 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 triggered by the cough reflex are also responsible for vomiting. It is not usually something to be overly concerned about.

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In this article, we look at why someone might cough so hard that they vomit. We also examine the treatment options, and when to see a doctor about a bad cough.


Senior man coughing.
Potential causes for coughing that leads to vomiting include respiratory conditions, such as asthma and COPD.

There are many different reasons why someone might cough so hard that they vomit. These include the following:

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 mucus, germs, and foreign particles cannot be cleared from the airways properly. Hence why many smokers have chronic coughs, lasting many weeks or months.

A smoker’s cough, as it is called, 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 commonly found in long-term smokers.

This disease 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.


Asthma is a condition marked by a chronic cough caused by inflammation in the lungs. The airways react to an allergen or irritant by narrowing, which is what triggers the coughing.

A chronic cough is sometimes the only sign of asthma, but 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.


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

A severe infection known as RSV or respiratory syncytial virus is the leading cause of bronchiolitis and pneumonia in children younger than 1 year in the United States.

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 that can sometimes be severe.

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.


Diagnosing a chronic cough starts with a thorough medical history and physical exam. The doctor will ask about symptoms and things that trigger or relieve the cough.

During the physical exam, the doctor will use a device called a stethoscope to listen to the chest. The doctor can tell whether fluid is in the lungs or if an airway obstruction is present based on the sounds that are produced as the person breathes.

Additional tests may be requested, based on the results of the medical history and physical examination. These tests can include:

  • chest X-ray
  • CT scan
  • lung function test
  • spirometry to determine air intake and signs of asthma
  • bronchoscopy to look at the lungs and airways with a camera

When to see a doctor

A chest x-ray may be used to diagnose respiratory problems.
A chest X-ray may be used to diagnose respiratory problems.

A single episode of coughing so hard that a person vomits is not a reason to call the doctor. However, people should seek medical help if they have a chronic or a severe cough that does not improve within a week or two.

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

  • coughing up blood
  • difficult breathing
  • fast breathing
  • blue lips, face, or fingertips

Prompt treatment is needed if any of these symptoms are present, as they can signal that someone is having difficulty breathing.

If a doctor cannot be reached, a person should go to the nearest emergency room.

Home remedies

Drinking herbal tea.
Drinking lots of fluids, including warm fluids such as herbal teas infused with honey, may help to ease coughs.

Several things that can be done at home to treat a cough before someone sees a doctor. The remedies depend on the cause of the cough.

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

Heartburn that is so severe that it causes a cough, which cannot be relieved by medication, should be evaluated by a doctor.

For a smoker who has a long-term cough, the priority should be to quit smoking. 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 the doctor for help to quit or check out www.smokefree.gov for additional resources.

If a cough is caused by an infection, these home care measures might help:

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

People should check in with the doctor if home care measures do not help a cough within a week or two, or it worsens.


Treatment for coughing so hard you vomit involves managing the underlying condition that is causing the cough.

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

  • antibiotics for an infection
  • prescription-strength cough suppressants
  • prescription acid reducers for GERD
  • decongestants or antihistamines for allergies
  • inhaler or steroids for asthma or allergies

People should be sure to follow up with their doctor if the cough is not relieved by the prescribed medication.


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

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

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

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