Gurgling in the Throat: Why It Happens

What causes a gurgling sound in the throat

The sound itself always means the same thing: air bubbling through liquid. What matters is where the liquid comes from.

Mucus and post-nasal drip

The most common cause. With a cold, sinus infection or allergies, mucus drips down the back of the nose into the throat (post-nasal drip). It collects above the voice box and gurgles when you breathe or talk, especially when you first lie down or wake up. Clearing your throat or coughing removes it for a while.

Acid reflux

In GERD, stomach contents travel up the esophagus. You may hear or feel gurgling in the throat or chest, often after meals or when lying down, with heartburn, a sour taste, burping or hoarseness. Laryngopharyngeal reflux ("silent reflux") reaches the throat with little heartburn and causes throat-clearing, a lump feeling and excess mucus.

Swallowing difficulty and aspiration

When the swallowing muscles do not move food and liquid efficiently, some stays in the pockets at the base of the tongue and around the voice box. This causes a "wet" or gurgly voice after swallowing, coughing during meals, and a sense of food sticking. Some may slip into the windpipe (aspiration), which can lead to chest infections. Common reasons for dysphagia include stroke, Parkinson's disease, motor neuron disease, head and neck cancer treatment and aging.

Zenker's diverticulum

A pouch that forms at the top of the esophagus in older adults. Food collects in it and comes back up later, sometimes undigested, with gurgling noises in the neck, bad breath and coughing at night. Zenker's diverticulum is diagnosed with a barium swallow X-ray.

Lung conditions

Mucus brought up from the lungs in bronchitis, COPD, bronchiectasis or pneumonia can gurgle in the throat before it is coughed out. A rattling chest sound and a productive cough point to a lung source.

Weak cough or reduced consciousness

People who cannot cough or swallow saliva effectively, such as after a severe stroke, under heavy sedation, or near the end of life, can develop loud gurgling breathing from secretions pooling in the throat. In the last days of life this is sometimes called the "death rattle". It usually distresses onlookers more than the person, and repositioning and medicines to dry secretions help.

Gurgling in babies

Babies often make gurgling and snuffly sounds because their nasal passages are narrow and they produce a lot of saliva. Spit-up and normal infant reflux also cause gurgles. This is usually harmless if the baby feeds well, gains weight and breathes comfortably. Seek care if gurgling comes with fast breathing, chest pulling in, poor feeding, coughing or color change during feeds, or a fever of 38 °C (100.4 °F) or higher in a baby under 3 months.

Clues to the cause

How doctors find the cause

A doctor will ask when the gurgling happens, whether it relates to eating, and about coughing, choking, heartburn, weight loss and chest infections. They examine the nose, throat and neck and listen to the lungs. Depending on the findings:

• Swallowing assessment by a speech-language pathologist
• Flexible endoscopic evaluation of swallowing (FEES): a thin camera through the nose watches you swallow
• Videofluoroscopy or barium swallow: X-ray videos of swallowing to look for aspiration or a pouch
• Upper endoscopy or pH testing for reflux
• Chest X-ray if pneumonia is suspected

Treatment and home care

• For mucus: drink plenty of fluids, use saline nasal sprays or rinses, and treat allergies with a steroid nasal spray or antihistamine. Steam may help thin secretions.
• For reflux: avoid large late meals, raise the head of the bed, cut down on alcohol, caffeine and fatty food, and stop smoking. Antacids or acid-reducing medicines can help; follow the label dose.
• For swallowing problems: a speech-language pathologist teaches safe swallowing techniques such as tucking the chin, taking small sips, and changing food and drink textures. Sit upright to eat and for 30 minutes afterward.
• For Zenker's diverticulum: a procedure through the mouth or neck to divide the muscle and remove or open the pouch.
• For pooled secretions: suction, positioning on the side, and medicines that reduce saliva.

Frequently asked questions

Why does my throat gurgle when I breathe?

Usually because mucus or saliva is sitting at the back of the throat, most often from a cold, allergies or post-nasal drip. Air bubbles through it as you breathe. If it clears with a cough it is rarely serious. Persistent gurgling with breathlessness or fever needs a check.

Why does my throat gurgle after I drink or eat?

A gurgle or wet voice after swallowing can mean some food or liquid has stayed in the throat instead of passing into the esophagus. Occasional episodes are normal. If it happens often, with coughing or choking at meals, ask for a swallowing assessment.

Why does my throat gurgle when I lie down?

Lying flat lets mucus from the nose drain into the throat and lets stomach contents reflux upward. Raising the head of the bed, avoiding food for 3 hours before bed and treating nasal congestion often reduce night-time gurgling.

Is gurgling in the throat a sign of pneumonia?

Not by itself. But gurgling or coughing during meals followed by fever, a wet cough and breathlessness can mean food or liquid has entered the lungs and caused aspiration pneumonia. This is especially a risk in older adults and after a stroke.

Is it normal for a baby's throat to gurgle?

Yes, mostly. Babies have narrow airways, lots of saliva and frequent spit-up, so gurgling sounds are common. Seek care if the baby is breathing fast, the chest pulls in, feeding is poor, or the baby coughs, chokes or changes color during feeds.