Acid Reflux Cough Explained: Symptoms, Triggers, Treatment

Yes, acid reflux can cause coughing. According to the American College of Gastroenterology report, over 60 million Americans experience acid reflux at least once a month, with many suffering from a related symptom known as acid reflux cough. 

This cough is a direct result of the irritation and inflammation caused by stomach acid that has refluxed into the esophagus and sometimes up into the throat and larynx. The presence of acid outside the stomach triggers a reflex designed to protect the respiratory system, resulting in a cough.

This reflex action is the body's way of attempting to expel the irritating substance and protect the lungs from aspiration.

Coughing caused by acid reflux is typically chronic and can be exacerbated by certain triggers, such as lying down after eating, consuming certain foods that increase acid production or reduce lower esophageal sphincter tone (e.g., fatty foods, caffeine, chocolate, and alcohol), and lifestyle factors like obesity and smoking.

The cough is often worse at night due to the lying position, which can allow acid to travel more easily back into the esophagus.

An acid reflux dry cough is a significant and uncomfortable symptom experienced by many individuals suffering from gastroesophageal reflux disease (GERD). This type of cough is characterized by a persistent, dry sensation that does not produce mucus.

It is primarily caused by the irritation of the throat and airways due to the reflux of stomach acid into the esophagus. The absence of mucus makes this cough particularly frustrating, as it often feels unproductive and can lead to a continuous cycle of coughing that further aggravates the throat, potentially worsening the symptoms of acid reflux itself.

The mechanism behind an acid reflux-induced dry cough lies in the body's natural response to clear the irritants from the throat and airways. When stomach acid travels back up into the esophagus, it can reach the throat and even the larynx, leading to irritation and inflammation.

This irritation triggers a cough reflex as the body attempts to protect the airways and remove the acid. However, since the cough is dry, it does not bring up any acid or mucus, leading to a cycle of persistent coughing that can be difficult to manage.

Symptoms of an acid reflux cough can often be mistaken for those of a respiratory condition, such as asthma or a viral infection. However, this cough has distinct characteristics that can help differentiate it from other types of coughs.

It is usually a chronic, dry cough that does not produce phlegm and is particularly prevalent at night or early in the morning. This timing is due to the increased likelihood of acid reflux when lying down, as gravity no longer helps to keep stomach contents in place.

Other symptoms accompanying an acid reflux cough may include:

• A hoarse voice, especially in the morning, due to irritation of the vocal cords by stomach acid.
• A persistent sensation of something being stuck in the throat.
• Frequent throat clearing.
• Bouts of coughing that worsen after meals or when lying down.

These symptoms collectively point towards acid reflux as a potential cause, especially in the absence of respiratory infections or conditions like asthma.

Treating an acid reflux cough involves a multifaceted approach aimed at reducing the frequency and intensity of reflux episodes, thereby minimizing the irritation and inflammation of the esophagus and airways that can lead to coughing.

Lifestyle Modifications:

• Dietary Changes: Avoid foods and drinks that trigger reflux. Eat smaller meals more frequently to reduce stomach pressure and avoid eating close to bedtime to prevent nighttime reflux.
• Elevating the Head of the Bed: This can reduce nighttime symptoms by utilizing gravity to keep stomach acids from traveling back into the esophagus.
• Weight Loss: For overweight individuals, this can decrease the pressure on the stomach that contributes to reflux.
• Quitting Smoking and Limiting Alcohol Consumption: Both can relax the lower esophageal sphincter and increase the risk of acid reflux.

Medications:

• Antacids: Provide quick relief by neutralizing stomach acid.
• H2 Receptor Antagonists and Proton Pump Inhibitors: Reduce acid production, giving the esophagus time to heal from any irritation or damage caused by acid reflux.

Surgical Options:

• In severe cases, or when lifestyle changes and medications do not provide sufficient relief, surgical options such as fundoplication may be considered. This procedure involves wrapping the top of the stomach around the lower esophagus to strengthen the sphincter and prevent reflux, thereby addressing the root cause of the cough and other reflux-related symptoms.