Hi Liz, I found this response on RareConnect re coughing and MSA. https://www.rareconnect.org/en/community/multiple-system-atrophy/learn/faq/i-cough-and-choke-after-meals "This could be a sign that you have a problem swallowing. Coughing is a normal reaction to help prevent food going into your lungs and causing infection. A speech therapist can assess the strength of your swallow and together with a dietician will advise on the best type of food for you."

I also read that chewing gum can help. Do you have a speech therapist?