Managing Acid Reflux Cough: Essential Insights and Tips

What is Acid Reflux Cough?

Acid reflux cough is a common symptom of gastroesophageal reflux disease (GERD), a condition where stomach acids unintentionally flow backward into the esophagus. This backwash of acid can cause irritation in the lining of your esophagus, leading to a persistent cough. This link between acid reflux and coughing is significant, with Frontiers studies indicating that approximately 10–59% of chronic cough cases are caused by GERD.  Unlike typical coughs, which are responses to blockages or irritants in the airways, an acid reflux cough is triggered by the acidic contents that reach the throat, often causing significant discomfort and a burning sensation known as heartburn. 

Symptoms Associated with Acid Reflux Cough

Acid reflux cough is typically accompanied by several other symptoms that can affect your overall comfort and quality of life. Common symptoms include:

• Hoarseness: A raspy, strained voice that is noticeably different from your normal voice.
• Chest Pain: A sharp or burning sensation that can be mistaken for heart-related issues but is localized near the heart.
• Sensation of a Lump in the Throat: Often described as feeling like something is stuck in the throat.

Dr. Anju Malieckal, a dual board-certified gastroenterologist in New York City and an assistant professor at the NYU Grossman School of Medicine, highlights the broader impact of these symptoms: "Acid reflux can complicate simple activities like swallowing and can even lead to a sore throat, making everyday tasks uncomfortable."

These symptoms, while troubling, can serve as indicators for individuals to seek further evaluation and management strategies to alleviate their discomfort and prevent more serious complications associated with GERD.

What Causes Acid Reflux Cough?

Acid reflux cough is primarily caused by issues with the lower esophageal sphincter (LES), the muscle that acts as a valve between the stomach and esophagus. Normally, the LES closes as soon as food passes through it. However, if the LES is weak or relaxes inappropriately, it can lead to stomach acids flowing back into the esophagus, a condition known as acid reflux. This backflow irritates the lining of the esophagus and triggers coughing. Here are the main factors that can contribute to this condition:

• Weak Lower Esophageal Sphincter: The LES can be weakened by various factors, reducing its ability to function properly.
• Obesity: Excess body weight can increase abdominal pressure, which can cause or exacerbate acid reflux.
• Diet: Consumption of foods and drinks that can relax the LES, such as chocolate, peppermint, fatty foods, coffee, and alcoholic beverages.
• Smoking: Tobacco use can decrease the strength of the LES and increase stomach acid production.
• Medications: Certain medications can relax the LES, increasing the risk of acid reflux.
• Hiatal Hernia: This condition occurs when the upper part of the stomach bulges through the diaphragm into the chest cavity, impairing the function of the LES.

Understanding these triggers is essential for managing and preventing acid reflux cough effectively.

Diagnosing Acid Reflux Cough

Diagnosing acid reflux cough involves a series of steps that help doctors determine whether acid reflux is the root cause of the cough. The diagnostic process typically begins with a detailed review of the patient's medical history and a physical examination. Doctors look for common symptoms associated with acid reflux, such as heartburn, throat irritation, and the sensation of a lump in the throat, in addition to coughing.

Steps to Diagnosis:

1. Medical History Assessment: This involves discussing the patient's symptoms, dietary habits, lifestyle, and any history of digestive issues.
2. Physical Examination: Doctors may examine the throat to check for signs of inflammation or irritation.
3. Barium Swallow Test: An X-ray imaging test where the patient swallows a barium solution that helps visualize the esophageal passage to detect abnormalities.
4. Endoscopy: A more direct examination where a flexible tube with a camera is inserted down the throat to view the esophagus and stomach.
5. pH Monitoring: Measures the acidity in the esophagus over a 24-hour period, determining if and when stomach acid enters the esophagus.
6. Esophageal Manometry: Tests the movement and pressure in the esophagus and the functionality of the LES.

If you're experiencing symptoms that suggest acid reflux might be causing your cough, using Symptom Checker can be an initial step to better understand your condition. While this online tool provides useful preliminary insights, it is not a substitute for professional medical advice. Always consult a healthcare provider for an accurate diagnosis and a tailored treatment plan.

Treatment and Management of Acid Reflux Cough

Medical Treatments

For those whose symptoms do not improve with lifestyle changes alone, medical treatments may be necessary. Here’s an overview of the options:

• Antacids: These over-the-counter medications provide quick relief by neutralizing stomach acid but do not treat the underlying cause of acid reflux.
• H2-Receptor Antagonists: Reduce stomach acid production and are available both OTC and by prescription.
• Proton Pump Inhibitors (PPIs): These drugs are more effective at reducing acid production and are used for severe cases. They are available via prescription or over the counter.
• Surgery: In severe cases, where lifestyle changes and medications do not suffice, surgical options like fundoplication might be recommended. This procedure involves wrapping the upper part of the stomach around the lower esophageal sphincter to strengthen it and prevent reflux.

Home Remedies and Natural Treatments

Many individuals find relief from acid reflux symptoms with home remedies and natural treatments. While these should not replace medical advice, they can be effective as supplementary treatments:

• Ginger Tea: Known for its gastrointestinal soothing effects, ginger can reduce inflammation and help relieve nausea and acid reflux.
• Aloe Vera Juice: Aloe vera can soothe the gastrointestinal tract and ease symptoms of acid reflux.
• Baking Soda: A teaspoon of baking soda in water can neutralize stomach acid and provide temporary relief.
• Chewing Gum: Chewing gum increases saliva production, which can help neutralize stomach acid.

By combining lifestyle changes, medical treatments, and home remedies, individuals suffering from acid reflux cough can find substantial relief and improve their overall health. Remember, it’s important to consult with a healthcare provider to ensure that you choose the safest and most effective treatment options for cough management and your specific situation.

Preventing Acid Reflux Cough

Preventing an acid reflux cough involves understanding and avoiding the triggers that exacerbate the condition. By maintaining a healthy lifestyle and making informed choices, you can significantly reduce the likelihood of experiencing acid reflux symptoms. Here’s a quick-reference checklist of do’s and don’ts to help manage and prevent acid reflux cough:

Do:

• Maintain a healthy weight: Extra pounds can pressure your stomach, pushing acid up into your esophagus.
• Eat smaller, more frequent meals: Large meals can overwhelm your stomach, causing acid to back up.
• Stay upright after eating: Give your body time to digest before lying down; wait at least three hours.
• Wear loose-fitting clothes: Tight clothing can squeeze your stomach area and push acid up into the esophagus.
• Elevate the head of your bed: Raise the head of your bed by 6 to 8 inches to help keep acid in your stomach.

Don’t:

• Lie down immediately after eating: Lying down can promote the movement of stomach contents back into the esophagus.
• Consume trigger foods and drinks: Avoid chocolate, mint, spicy foods, caffeine, and alcoholic beverages.
• Smoke: Smoking decreases the effectiveness of the lower esophageal sphincter and increases acid production.
• Overuse over-the-counter antacids: While they can provide quick relief, they do not prevent acid reflux and can mask symptoms.

When to See a Doctor

While many cases of acid reflux can be managed with lifestyle changes and over-the-counter medications, it’s important to know when to seek professional help. Consider seeing a doctor if you experience:

• Persistent or worsening symptoms: If your symptoms of acid reflux persist despite making lifestyle changes and using over-the-counter medications.
• Symptoms several times a week: Frequent acid reflux could indicate GERD, which requires medical intervention.
• Difficulty swallowing: This can be a sign of esophageal damage from stomach acid.
• Unintended weight loss: Losing weight without trying can indicate a serious underlying condition.
• Pain or discomfort in the chest for any duration: To rule out heart-related issues.

If you experience any of these symptoms, it’s crucial to consult a healthcare professional to get the right diagnosis and treatment.