GERD and Cough
Acid Reflux or "GERD": One Possible Cause for Chronic Cough
Acid reflux — also known as heartburn or “GERD” (gastroesophageal reflux disease) — is a potential cause for ongoing cough. Your cough might be related to acid reflux if you have:
· pain in the center of your chest
· a sour taste in your mouth
· a sense that food is coming back into your throat after eating
· a tickle at the base of your throat that has not responded to allergy medicine
When acids from digestion flow backward into the esophagus or larynx (“voice box”), they can stimulate cough receptors in the throat. But it is possible to have this kind of cough even if you don’t experience heartburn. Research shows that up to 60% of acid reflux is “silent.” This means that since it doesn’t cause pain/discomfort, you don’t know it’s happening.
Mechanisms of Cough Related to Acid Reflux
A cough of this kind can be caused directly, by acid stimulating cough receptors in the throat. It could also be related to irritation or inflammation caused by exposing the lining of the esophagus to acids on an ongoing basis. Some people continue to cough despite treatment with acid-suppressing medication. Some scientists think that other substances (bile, pepsin, other gastric enzymes) can trigger the cough, and that dietary modification may be able to reduce cough.
Unfortunately, cough and acid reflux can “go both ways” — i.e. acid reflux can trigger cough but cough can also trigger acid reflux. So it’s possible to get into a “vicious cycle” of reflux triggering cough and cough triggering more reflux.
Evaluation at the Cough Center
At the Cough Center, we will discuss your cough in detail. This may include questions about:
· how long you’ve been coughing
· whether your cough happens at certain times of day or certain seasons of the year
· anything that makes your cough better or worse
· household or workplace exposures
· treatments you’ve tried
· labs or imaging studies you’ve had done
· other medical issues you’ve had in the past or are currently dealing with
Treatment for GERD due to Cough
There are two main categories of medication for a cough caused by acid reflux, Histamine-type-2 blockers and Proton pump inhibitors.
Sometimes patients will respond well to one of these categories of medicine. Sometimes we will prescribe a medicine from each category for a period of time. Some cough is triggered by mechanisms that these medicines cannot fix. If the cough does not respond to medication, dietary changes may be needed. We can work with you to identify foods that may need to be reduced or even eliminated.