Why do you keep gagging without throwing up? (+15 reasons)

In this article, we will discuss possible reasons for gagging without throwing up. We will also discuss some clinical interventions to reduce gag reflex.

Why do you keep gagging without throwing up?

You may keep gagging without throwing up because of psychological disorders (such as anxiety, smell, and taste), iatrogenic factors (such as dental procedures), and anatomic factors (stimulation of the posterior pharyngeal wall or the base of the tongue) (1).

It may also occur due to local and systemic factors such as acid reflux, laryngopharyngeal reflux (LRP), postnasal drip, persistent cough and other diseases (1). Gagging without throwing up is known as retching or dry heaving.

In retching the patient thinks he wants to vomit but nothing comes up. Retching happens when your diaphragm and abdominal muscles contract to expel the stomach content through the oesophagus but your body is unsuccessful in doing so.

What factors cause gagging without throwing up?

Some of the factors that can cause gagging without throwing up include:

  • Pregnancy: Hormonal changes, morning sickness, acid reflux, and heartburn during pregnancy might trigger gag reflux.

Gagging often improves between weeks 12 and 20, but it can linger longer for some pregnant women.

  • Anxiety and stress: During anxiety and stress the muscles of the mouth and throat tend to tighten.

This may trigger an anxiety gagging. Stimulation of the vagus nerve due to stress and anxiety can activate the gag reflux.

  • Brushing teeth: While brushing the teeth, the back side of the tongue triggers pharyngeal or gag reflux. 

The gag reflux might also be caused by taste sensitivity triggered by minty taste or chemicals present in the toothpaste.

  • Food: Inadequate chewing, eating too fast, or eating something which you dislike might trigger sensitive gag reflux. 
  • Dental issue: Use of instruments during dental check, and dental treatment can cause gagging without throwing up. 
  • Smell: Gagging occurs when the cell in the nose detects a caustic chemical or food that you don’t like and warns the brain about potential danger.
  • High altitudes: Ascending too rapidly at high altitudes can cause altitude sickness which is characterized by nausea, gagging, and vomiting.
  • Chemotherapy: According to research, 50-60% of the patients who get moderate or strong emetogenic chemotherapy develop delayed vomiting (2).

What disease causes gagging without throwing up?

Patients with certain kinds of diseases may also experience gagging without throwing up. Such conditions involve:

  • Acid reflux: Gastroesophageal reflux syndrome (GERD) causes acid reflux and heartburn. During this, the patient might feel like throwing up in an attempt to empty the stomach.
  • Postnasal drip: In case of severe postnasal drip, the patient gags without throwing up because of the extra mucus in the stomach.

Postnasal drip and gagging are common in inflammatory diseases such as rhinitis, hay fever and sinusitis. Gag reflux can also be triggered by viral infections such as bronchitis, cold and flu.

  • Persistent cough: Bronchitis may cause persistent cough. In an attempt to remove a large amount of mucus, the body may also trigger a gag reflux.
  • Laryngopharyngeal reflux (LRP): During GERD, when the stomach acid moves up the oesophagus and travels into the throat (larynx and pharynx) then it is known as LRP.
  • Allergic reaction: Severe allergic reaction may cause breathing difficulty, gag reflux, and choking.
  • Swallowing dysfunction: In oropharyngeal dysphagia, the patient feels that the food is going up his throat and nose while swallowing. This triggers gag reflux.
  • Esophageal spasm: It might cause difficulty in swallowing, gag reflux and chest pain when taking food. The oesophagus is the tube that takes food into the stomach.

How can you prevent gagging without throwing up?

As gagging is an involuntary action, preventing or treating the underlying cause may ward off gagging.

  • Proper brushing of teeth: Hypersensitive gag reflux during brushing can be prevented by using a small-headed toothbrush.

An electric toothbrush can also be used to prevent gagging. Gargle with warm water before brushing your teeth to relax the throat and buccal area. Hold the brush at a 45° angle and slowly brush the teeth.

  • Numbness: Using sedatives and local anaesthesia can numb the area during dental procedures. This can prevent pain, and gagging, and help with anxiety.
  • Antidepressants: Antidepressants can reduce the occurrence of anxiety and depression causing gag reflux.

However, some antidepressants like Bubripoin and Effexor are known to cause gagging. Effexor is also known to cause GERD which can trigger gag reflux.

  • Antacids: GERD can be treated with antacids like aluminium hydroxide, Gaviscon, and pepto-bismol.
  • Decongestants: Congestion and postnasal drip can be treated with decongestants like pseudoephedrine.

In my teens, I often used to gag while eating eggs. The sight and smell used to make me want to throw up even before tasting it. However, with time it went away on it own. It was more of a pscyhological factor rather than an allergic reaction.

If you experience excessive gagging while brushing and eating, you should consult your doctor. Sometimes we overlook other associated symptoms like heartburn, stomach problem, dental issue, or possibility of an infection.

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Hainsworth JM, Hill KB, Rice A, Fairbrother KJ. Psychosocial characteristics of adults who experience difficulties with retching. Journal of dentistry. 2008 Jul 1;36(7):494-9. https://www.sciencedirect.com/science/article/abs/pii/S0300571208000973


Wood JM, Chapman K, Eilers J. Tools for assessing nausea, vomiting, and retching: A literature review. Cancer nursing. 2011 Jan 1;34(1):E14-24. https://journals.lww.com/cancernursingonline/Fulltext/2011/01000/Tools_for_Assessing_Nausea,_Vomiting,_and.14.aspx?casa_token=9rwmuNk76lUAAAAA:NtfEUZZhx9VKeYP0m_IgEMsjKy9AYv1ncdxn4-iwL5sKx0Uw5Gf5vZGodKgoUKiRofPlyzrq6e23NsUSIzWNKQLN