A 45-year-old female who had undergone Nissen fundoplication for long-standing laryngopharyngeal reflux (LPR) developed episodes of coughing and throat clearing. Strobovideolaryngoscopy demonstrated evidence of LPR with a reflux finding score of 11. A cough workup including a chest X-ray and pulmonology consultation was negative. Consultation with a nutritionist revealed Histamine intolerance. Histamine-free diet resulted in marked improvement in patient's symptoms and examination.