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What is GERD Cough?

Published in GERD and Cough 3 mins read

GERD cough is a persistent, usually dry cough caused by gastroesophageal reflux disease (GERD), where stomach acid flows back up into the esophagus. This backflow can irritate the esophagus and trigger a cough reflex.

Understanding GERD Cough

  • Cause: GERD cough is a result of stomach acid irritating the esophagus or even the airways, triggering the body's natural cough reflex. This happens when the lower esophageal sphincter (LES), which usually prevents stomach contents from flowing back up, malfunctions.

  • Characteristics:

    • Often a dry cough (not producing phlegm).
    • May worsen at night or when lying down.
    • Can be chronic, lasting longer than 8 weeks.

  • Associated Symptoms: While heartburn is a common symptom of GERD, some people with GERD cough may not experience heartburn. Other possible symptoms include:

    • Regurgitation of food or sour liquid
    • Hoarseness
    • Sore throat
    • Feeling of a lump in the throat
    • Wheezing

Diagnosis

Diagnosing GERD cough can be challenging, as other conditions can cause similar symptoms. Doctors typically use a combination of methods:

  • Medical History and Physical Exam: Discussing your symptoms and medical history helps the doctor assess the possibility of GERD cough.
  • Empirical Treatment: The doctor may suggest a trial of medications used to treat GERD, such as proton pump inhibitors (PPIs), to see if the cough improves.
  • Diagnostic Tests: In some cases, further testing may be necessary:
    • Esophageal pH monitoring: Measures the amount of acid reflux in your esophagus.
    • Esophageal manometry: Measures the function of the esophagus and LES.
    • Upper endoscopy: Visualizes the esophagus and stomach using a thin, flexible tube with a camera.

Treatment

Treatment for GERD cough focuses on reducing acid reflux and soothing the irritated tissues:

  • Lifestyle Modifications:

    • Elevating the head of your bed.
    • Avoiding trigger foods (e.g., caffeine, alcohol, chocolate, fatty foods).
    • Eating smaller, more frequent meals.
    • Not eating for 2-3 hours before lying down.
    • Quitting smoking.
    • Maintaining a healthy weight.

  • Medications:

    • Antacids: Provide quick, temporary relief from heartburn, but don't heal the esophagus.
    • H2 receptor blockers: Reduce acid production in the stomach.
    • Proton pump inhibitors (PPIs): More powerful acid reducers, often used for longer-term treatment.
    • Prokinetics: Help the stomach empty faster, reducing the chance of reflux (less commonly used due to side effects).

  • Surgery: In severe cases, surgery (e.g., fundoplication) may be an option to strengthen the LES and prevent reflux.

In summary, GERD cough is a chronic, often dry cough resulting from stomach acid refluxing into the esophagus and airways, requiring lifestyle changes, medication, or, in rare instances, surgical intervention.

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