Gastroesophageal reflux disease, or GERD, describes a more serious form of gastroesophageal reflux---a condition caused when the ring of muscle known as the lower esophageal sphincter, which separates the stomach and esophagus, fails to close or opens spontaneously. Patients with gastroesophageal reflux suffer from acid indigestion, or heartburn, when stomach acid rises into the esophagus. In addition to the chronic burning sensation, gastroesophageal reflux disease can cause a dry, persistent cough.
Contributing Factors
Although the exact cause for each individual case of GERD may go undetermined, many factors can contribute to the onset of this disease. Patients who suffer from a hiatal hernia, a condition that occurs when the upper portion of the stomach and the lower esophageal sphincter move above the diaphragm, are at risk of developing GERD, according to the National Digestive Diseases Information Clearinghouse. Other factors that contribute to GERD and cough symptoms include obesity, pregnancy, smoking and ingesting certain foods, such as citrus, chocolate, spicy foods or caffeine.
Cough Mechanism
A cough occurs as an involuntary reflex response to an irritant in the airways or esophagus. In the case of GERD, when acid raises into the esophagus it causes irritation that triggers the cough reflex. After long periods of time, some patients experience the cough even in the absence of acid in the esophagus, as revealed by research published by The International Society for the Study of Cough. This suggests that patients develop an increased sensitivity of cough receptors in the esophagus.
Diagnosis
A chronic cough can be difficult to diagnose. To help patients determine the cause of their cough doctors suggest keeping a diary to record when coughs occur and circumstances leading up to the cough. Assessing concurrent symptoms, such as the presence of the burning sensation or trouble swallowing, can also help doctors and patients pinpoint the cause of the cough as GERD.
Lifestyle Changes
To relieve a cough caused by GERD, the underlying acid reflux must be treated. Committing to lifestyle changes can help control the cough symptoms of GERD. This includes quitting smoking, changes in diet, losing weight, sleeping with the head elevated and eating smaller, more frequent meals.
Medications
When lifestyle changes alone fail to improve the cough symptoms of GERD, doctors can suggest medications to control acid reflux. Over-the-counter antacids such as sodium bicarbonate can relieve mild symptoms of GERD by neutralizing stomach acid. For moderate to severe cases doctors can prescribe medications classified as H2 receptor blockers, such as ranitidine and famotidine, or proton pump inhibitors such as lansoprazole and omeprazole, to reduce the production of acid in the stomach.
