Coughing and Acid Reflux
Coughing is one of the body's protective mechanisms for removing foreign materials and excess fluid or mucus from the respiratory system and is a one of the main reasons people seek the help of medical professionals. Acid reflux has been identified as a cause of chronic coughing, and in fact, gastroesophageal disease accounts for one quarter of all patients who suffer from chronic cough (Cough Journal). This condition has been termed reflux cough.
GERD
Gastroesophageal reflux disease (GERD) is characterized by the regurgitation of stomach contents into the esophagus. This ailment is common in childhood and is associated with a variety of disorders of the respiratory system. Such problems include reactive airway disease, aspiration pneumonia, spasms in the larynx, choking, apnea, and chronic coughing. In certain cases, coughing may be the only symptom of GERD (American Association of Family Physicians).
Other Causes of Reflux Cough
Reflux cough can be exacerbated by certain foods such as chocolate, spicy foods or dry foods. Sometimes people with reflux cough find that their symptoms worsen even before they place the food in their mouths. Body positioning also plays a role in the aggravation of symptoms. Often people complain of increased coughing while lying or sitting down or in a bent over position. Talking, singing or laughing can also precipitate coughing. Stressful situations and times such as the holidays can increase acid reflux and therefore coughing. Most people with reflux cough find that their condition diminishes at night only to resume in the morning. This is due to the fact that the stomach valve closes while sleeping and reopens upon waking, which allows stomach contents and acids to escape into the esophagus.
The mechanism of the cause of reflux cough is suspected to be ultimately caused by inhalation of acidic stomach contents into the lungs, causing irritation. Increased sensitivity of cough receptors located in the esophagus has also been identified as a cause of reflux cough (International Society for the Study of Cough).
Treatment
A chronic cough that lasts longer than eight weeks requires medical attention and a chest X-ray. If the results of the X-ray do not reflect serious underlying disease, then reflux cough is one of only two possibilities for the cause of the cough (the other cause being asthma).
Reflux cough can be treated with prokinetic therapy. This therapy involves the administration of drugs that promote gastric emptying. Drug therapy is usually long-term and not always successful in bettering chronic cough. It also usually has a delayed response and must be initially prolonged until improvement in symptoms is observed. In cases where long-term drug therapy is not desirable or effective, there are minimally invasive surgical procedures available that strengthen the valve between the stomach and esophagus. Many patients who elect surgery experience a dramatic improvement in their quality of life.
