Gastric reflux, or GERD, is a common condition caused when stomach acid leaks back up into the esophagus. Chronic cough is an increasingly recognized symptom of reflux that may be more noticeable at the time of eating. Medications, diet and lifestyle changes can help improve the symptoms of gastric reflux.
Gastric Esophageal Reflux Disease
Swallowed food travels from your mouth, down the esophagus and into the stomach. A band of muscle, called a sphincter, surrounds the lower end of the esophagus and opens to let food pass, then closes again to prevent stomach acid from leaking back into the esophagus. With gastric reflux, the sphincter fails to stop the acid, resulting in irritation of the esophagus. Symptoms can include heartburn, bloating, gas, acid taste in the mouth and commonly a persistent cough.
Gastric Reflux Cough
More than 60 percent of people with reflux complain of a recurring cough, sometimes associated with eating, according to the July 2002 issue of "Respiratory Reviews." The opening and closing of the sphincter while eating allows acid reflux in some people, and a full stomach also puts more pressure on the sphincter. When stomach acid reaches the esophagus, it can stimulate a nerve reflex that leads to spasm of the airways and coughing. Coughing can also be caused by acid extending farther up the esophagus to the trachea, with direct irritation and spasm of the airways.
Diagnosis of Reflux Cough
Postnasal drip, gastric reflux and asthma are the most common causes of a cough lasting more than eight weeks, after excluding infection and smoking, according to Dr. W. Ross Lawler in the December 1998 issue of "American Family Physician." A history of heartburn or other acid symptoms supports gastric reflux as the cause, as does relief of the cough with anti-reflux medications such as cimetidine or omeprazole. Esophageal pH monitoring to check for acid in the esophagus might be performed to help confirm the presence of reflux. Additional medications or tests to exclude the presence of postnasal drip and asthma are often performed as well, since these conditions can co-exist.
Gastric Reflux Diet
Several dietary changes can be tried to relieve a cough due to gastric reflux, according to Patient UK. Eating smaller, high-protein and low-fat meals decreases symptoms of reflux for some people. Avoid any foods that seem to particularly worsen your cough, as well as foods commonly associated with reflux, such as tomatoes, spicy foods, chocolate and alcohol. Because lying down or bending over with a full stomach can worsen reflux, avoid these activities for two to three hours after eating. This includes not eating or drinking before going to bed.
Other Possible Changes
Other changes that can decrease gastric reflux and its symptoms include weight loss and stopping smoking. A variety of medications, such as aspirin and ibuprofen, can cause esophageal irritation and should be avoided when possible. Raising the head of your bed 4 to 8 inches can decrease acid reflux at night. Anti-reflux medications are also commonly prescribed, and discussing your condition with a health-care provider is important.
