What Can Stop the Chronic Acid Reflux Cough?


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Chronic or semi permanent cough is a symptom of acid reflux, and is commonly experienced by many suffers.   However, many people don’t realize that a chronic cough can be caused by or exacerbated by acid reflux, leading a an acid reflux cough. 

How does acid reflux result in coughing?  When acid flows back up the esophagus, the esophagus reflexes which results in a spasm of the airways that can lead to shortness of breath and/or coughing.   A cough can also result when certain nerves within the esophagus related to the lungs are irritated, which triggers coughing.  Thus, acid reflux can cause coughing without ever passing into the throat. It is not uncommon for a cough to be the only acid reflux symptom a person experiences.

Those who suffer from chronic cough usually have frequent cases of reflux that are so severe that they can experience…

Throat and larynx inflammation and damage – If refluxed acid enters the throat and voice box it can cause inflammation which can lead to swelling of the throat tissue.  The inflammation and swelling can result in a sore throat and hoarsens, causing coughing.  Over time, the constant assault of acid on the throat can lead to damaged throat tissue.  When the throat is damaged or inflamed, the throat is irritated, and coughing can result.

Aspiration of acid into the lungs – refluxed acid that passes the larynx can invade the lungs.  When acid is refluxed into the lungs this is known as aspiration and can result in coughing and choking.  Over time, aspiration can cause damage to lung tissue which can lead to fibrosis (progressive scarring).  Aspiration can occur with or without symptoms, and can lead to lung infections that result in pneumonia.  Aspiration primarily occurs at night because the digestive processes that help to prevent reflux and the coughing reflex that is designed to protect the lungs are inactive.

Keep in mind; although it is clear that GERD (gastroesophageal reflux disease) can cause and/or exacerbate coughing, it is still not clear how often the symptom of coughing is directly related to acid reflux.

How is chronic cough caused by acid reflux treated?  If you suspect that your chronic cough is caused by acid reflux, the best way to treat your cough is to treat your acid reflux.  Understand, if your chronic cough is the result of acid reflux, taking over-the-counter medications designed to treat cough due to colds or allergies won’t be beneficial to you.  Your goal is not simply to treat coughing symptoms as they occur, it is to prevent the cough by preventing acid reflux.  Therefore, the following are some suggestions on how you can attempt to ease a chronic cough:

Lifestyle change:  A lifestyle change involves –
Alter eating habits - avoiding foods that are known to trigger acid reflux (I.E. fatty and spicy foods, chocolate, caffeinated beverages, citrus juice and fruits, alcohol, etc.), as well as eating smaller and frequent meals.
- Lose weight – if you are overweight, losing weight will take pressure off your lower esophageal sphincter (LES), which reduces the risk of reflux.  Engage in exercises such as walking, swimming and cycling.  These exercises will not place pressure on your stomach or LES.  You should wait for at least an hour after eating before exercising.
- Stop smoking – Smoking increases your risk of acid reflux, but it can also exacerbate chronic bronchitis, which could be something you are suffering from if you are a smoker.
- Prevent acid reflux while sleeping - Acid reflux is more common when we sleep, because the defenses in the digestive system that help to prevent acid reflux are inactive.  Thus, to help stop acid reflux from occurring while sleeping, make sure you avoid eating and drinking two to three hours before you lie down.  You should also elevate your head approximately 4 inches when lying down to prevent acid from traveling up your esophagus.

It is important to note that while lifestyle changes can be very effective, improvement in your cough symptoms may be slow, and it may take months before your cough is completely cleared.

Medications for Acid reflux: - Taking medications that prevent and block the production of acid such as antacids (Tums) and H2  blockers (Zantac) can help alongside lifestyle changes in alleviating acid reflux symptoms.  Another medication known as a proton pump inhibitor is beneficial for those with GERD because it not only stops acid production, it also allows the esophagus healing time.  Medications designed to relieve acid reflux symptoms are generally safe for long-term use, but you should speak to you doctor first, as well as be monitored by your doctor if you decide to take any medications.

Other treatment:  If your chronic acid reflux cough is still not easing after trying methods to prevent and relieve acid reflux, it’s time for you to seek the help of your doctor.  He or she may prescribe a medication known as a bronchodilator which helps to relax the air passages in your lungs to sooth coughing.  This medication or another kind may be provided while the doctor runs tests to see if they can determine the cause of your cough, so that they can provide you with the best treatment method.


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30 Responses

  1. gilbert passarella
    January 22nd, 2009 | 2:23 pm

    hi kate: I enjoy your information on acid reflux and has helped me a great deal. thanks gil

  2. Diana
    January 23rd, 2009 | 3:43 am

    It seems that the cough described as related to GERD is a “dry” cough. When my cough is at it’s worst, I cough up lots of mucous/phlegm. This can happen during the night, but is mostly in the morning, until I can get most of the phlegm coughed up and out. I know that my sinuses are clear - so it’s not coming from there. I am convinced my chronic cough IS related to GERD. It sometimes presents with asthmatic symptoms: uncontrolled cough, difficult to catch a breath, etc., and a “rescue” inhaler will help at the moment.

  3. Don Mosier
    May 18th, 2009 | 5:17 pm

    I am a sufferer of a cronic Acid reflux cough and am going nuts. I can go two days with sleep and I think I am on the road to recovery and wham, I’m up all night with my acid reflux cough. I drink a lot of water trying to dilute the acid and most of the time it works, but not always. I take an acid reducer from COSTCO with 20mg of Famotidine, I cut one table and then take a total of 50mg a day (two tablets plus a half). I also take one 40mg ‘purple pill’ of Nexium each day at noon. My cough has been with me for 10 days. Very frustrating. I cough up a lot of mucous/phlem, especially at night and in the morning. As soon as all this garbage is out of my system, I’m okay most of the day until about 4:00PM, and I can feel the change as the mucous/phlegm get ready to attack me during the evening and late night. I’ve raised the bedposts 4 and 1/2 inches and I guess they help, especially when I sleep all night, then I’m a genius for raising the bed. Why doesn’t it work all nights???? I guess you have to be lucky. I’m going to ask my doctor about a bronchodilator, maybe that’s the key. I’m also taking a beta blocker and that could be helping the acid reflux.

  4. Kathy Bender
    June 20th, 2009 | 3:14 am

    About 10 years ago I developed a chronic cough after a year of going to ENT for sinus problems which were cleared up, the cough continued much to my dismay. I returned to the doctor who at that time provided me with Prevacid which was not OTC at the time and said if you stop coughing, we know the problem is GERD. ntil that time I had no idea that GERD could cause coughing. The Prevacid worked almost immediately and I was extremely excited. This worked for about 2 years, then my dosage was increased but the relief was not as immediate. In 2001, I had the reflux surgery and once again was relieved of my cough. Again two years passed and the cough returned. Prevacid was soon to be OTC and insurance would no longer pay and I was switched to Protonix. My coughing has been relatively controlled, but is now back with a vengence. A recent upper respiratory infection has put me on a viscious cycle and I have been unable to escape the coughing. Controlling bladder issues is a problem. I am desperate for relief of this coughing. Can you recommend something? Am I destined to have the surgery repeated? Help!!!

  5. Andi
    November 18th, 2009 | 4:54 pm

    I struggle with this issue. I am curious to whether you would suggest, also cutting back on tea?

  6. Ferguson
    April 20th, 2010 | 9:48 pm

    @Diana: I also cough up a lot of mucous and phlegm, and I also have it most reliably in the morning, or right after I eat food (especially greasy food or food in large quantities). My nose gets runny when this happens. Since I get these coughing fits mostly after I eat, is it related to damage in the esophagus? Maybe I’ve got scar tissue that food gets caught on. Do people with acid reflux often have issues because of scar tissue in the esophagus?

  7. October 11th, 2010 | 6:41 pm

    Your article was helpful. The only symptom I have is a persistent cough. I have been on Nexium for about 4 weeks but not seeing any improvement. Do you have any other suggestions?
    Brenda

  8. shenia gunn
    January 11th, 2011 | 6:34 pm

    I need information on foods to eat

  9. Kain
    January 28th, 2011 | 1:52 pm

    My cough started about 5 years ago and I had a difficult time believing it was GERD. The gastro doc performed an upper endoscopy and found a hiatal hernia in the stomach. So this confirms the dr’s suspicion. My cough is productive and a nuisance at work, especially in meetings and calls. While I am on Nexium it provides little relief. I may opt for surgery if it can’t be controlled soon. As a first step I am going to try to shed the extra fat in my gut. I’m not overweight but do need to lose what is becoming a beer belly. Through it all the hardest thing to give up is coffee!

  10. Garth
    June 3rd, 2011 | 7:11 pm

    This is such great info. I have acid reflux and have a hard time sleeping at night when I lay down then I start coughing all night. I just bought a Avana wedge and will see if that helps also.

  11. Sita
    June 15th, 2011 | 8:53 pm

    I need information on what foods I can eat every 2 hours to maintain my acid reflux down. Thanks

  12. June 16th, 2011 | 11:14 am

    There are a couple of posts that cover the diet basics that might be useful for you Sita. Take a look at the following:

    http://naturally-stop-acid-ref.....-symptoms/

    http://naturally-stop-acid-ref.....-reflux-2/

  13. Michelle
    June 22nd, 2011 | 11:19 pm

    Oh my gosh! I am so glad to find this article. I have had a chronic cough for over 4 years. It is very violent and I cough up phlegm and now blood as I have had this condition for so long. The docs original tried PPI’s thinking it was gerd, but these only made it 10 times worse. I have had every procedure done and nobody can help me. I have even been to the mayo clinic. I have not tried a bronchodialator, but maybe I should. I am very slim, fit, do not eat gluten, dairy or egg any longer and still have this condition. My concern is that it is going to be the death of me as one day I won’t be able to clear all of this phegm. any body???

  14. BEE
    July 19th, 2011 | 4:26 pm

    Great resource. Some suffer for years until they diagnose and treat this condition. It can easily be confused with other conditions. Once diagnosed the natural solutions are often more or equally as effective as medications.

  15. Carrie
    September 3rd, 2011 | 8:59 am

    It was so wonderful to read all of the above entries and to know that I am not alone. As I write this I am sitting up unable to sleep because of one of the coughing episodes. I had major surgery on my liver years ago and have since developed GERD. I am on two separate medications, one in the morning and one at night, I have altered my eating habits- ie no coffee etc. I still find that I just have some really bad nights with this cough. It feels like I can’t breathe and my chest feels full of mucus. It is very scary…

  16. Amy
    September 30th, 2011 | 3:50 pm

    Michelle,
    Have you been checked for anemia? I have had this cough for almost a year and a midwife told me when I discovered that I had anemia the cough could be related to my blood. You can be so low on blood that you organs are suffering and a cough can force oxygen into your lungs. I was very disappointed when my blood got better and the cough remained!

  17. Janis
    October 4th, 2011 | 2:13 am

    hi I have had my cough for 20 years. It’s a lot better in the summer but in the winter, I cough from October to May. My nose runs, there is mucus running down the back of my throat.
    I cough so much i can’t function. I have a young family and a job. I am becoming disabled by this. Nothing helps. Every doctor thinks it’s acid reflux. Why does it only bother me in the winter, then? Or that I have an allergy. Again, only in the winter? I don’t know what to do. I might go to the hospital tonight. I can’t sleep or eat or look after my kids. my husband is taking care of them.

  18. dale mullis
    October 6th, 2011 | 7:12 am

    I first get a tickle in my throat and then i start gagging like i am going to through up.Flem comes up real thick with bubbles in it almost chokes me to death but chewing gum and halls seem to help a little i live on those two things if anyone can help me out i would love it.

  19. Lorraine
    October 15th, 2011 | 8:56 pm

    @Janis
    I have had the exact same problem as you for as many years. However for the last 4 years I have managed to keep it under control by doing the following. I use a Neti Pot (sinus rinse) starting in September-October while I still feel fine and before the post nasal drip starts. I do this at least once a day but twice would be better. If the post nasal drip does get worse I then
    immediately start using Nasonex spray as per my physician’s instructions, as well as the Neti pot. By doing this, I have managed to keep my cough to a minimum.

  20. barbara
    October 21st, 2011 | 11:27 pm

    I just had another cat scan and it shows nothing yet I cough all the time. I cough when I least expect it without warning. I have been treated for years with gerd and I know that my cough is acid reflux! Its going to be difficult to stop my caffiene but I now have no choice as I desperately want to get rid of this cough. My lungs feel heavy and irritated. I have started back on the daily medication and take a zrtec for allergies. Its good to know I’m not alone but I feel so sorry for all of you. Hang in there keep trying let us know what works for you.

  21. ali
    October 25th, 2011 | 7:31 pm

    i have dry cough since 10 days and it really killing me.i cant sleep since 2 nights.cant lie down
    doctor said i have gerd and after eating medicines for gerd,this problem start so i have stop eating medicines.
    i dont know what to do,medicines for cough is not working

  22. Judy
    November 2nd, 2011 | 3:02 am

    I feel a prickly sensation in the back of my tongue which provokes couphing which leads to gagging. There are times it has made me vomit. I have read and read about GERD, googled prickly throat and pulled up the anatomy of the tongue to point out exactly the area thats affected. It seems nobody has my symptoms. If I have GERD, why aren’t my symptoms common?

    I’ve been to an ENT (tube down the nose) twice. The first time he said I had acid relux. I didn’t believe him. The second because I had an attack that really scared me. Insisting I had acid reflux, I saw a gastroenterologist, who performed an endoscopy procedure.The gastroenterologist said my stomach was acidy but didn’t diagnose it as acid reflux. Prolosec didn’t work nor does the prescription drug dexalant.
    Any suggestions?
    Dale Mullis wrote this and is the only person out of hundreds that described what I’m going through.

    “I first get a tickle in my throat and then i start gagging like i am going to through up.Flem comes up real thick with bubbles in it almost chokes me to death but chewing gum and halls seem to help a little i live on those two things if anyone can help me out i would love it.”

  23. Veera
    December 16th, 2011 | 10:30 am

    I had been coughing uncontrollably for over a month. The symptom was the same as stated in other comments. I first got a tickle in my throat and then I started gagging like I am going to through up.Flem comes up real thick with bubbles in it. The cough went away with this natural remedy. I ate two tablespoons of all natural sliced almond (without salt or any flavor added) three times a day.

  24. Ricky
    December 26th, 2011 | 6:27 am

    I have hard a chronic cough for 7 weeks. First doctor stated I had a virus and prescribed anti biotics with no improvement. I went back to same dr after the antibiotics. I explained the cough was the only real issue, was fairly non productive and very intense at night. He then prescribed a nasal inhaler and sleeping pills. At that point I realized he had no desire to administer a correct diagnosis. I later went to ER at a Vancouver Hospital. By the time I got to see the dr at the hospital I had more avenues he could pursue in my diagnosis. I told him I feel a strong pressure in my chest and in my throat as soon as I eat, and then in about ten minutes a cough ubcontrollably for 45minutes. The doctor subscribed Symbicort for COPD symptoms. I of course belived him and used the inhaler as he requested. It did nothing or me except make my tongue swell and cause me to loose my voice. I have stopped the inhaler and hope to get looked at for GERD which my symptoms are more inline with and make way more sense. I have had issues with gastronissues for years and gerd would be the most feasible issue.

  25. Carol
    January 2nd, 2012 | 3:58 am

    I totally lost my voice repeatedly and often for a couple months at a time. The cough becomes so harsh that I even cracked a rib. I have been on Prilosec daily for about a year. It took a long time, but the voice finally came back and the cough eventually went away. I don’t know what I did but the cough is back. I was on vacation and may have missed a dose or two of the Prilosec. While battling “tourista” I am also coughing violently again. I can’t remember if there was anything besides the prilosec that would help. I know the drug took a long time to fix the problem, although I lost my ability to sing and my speaking voice is always raspy. Any suggestions for the next couple months!

  26. Kim
    January 24th, 2012 | 10:27 pm

    I too didn’t believe my ENT when I was first diagnosed with reflux along with my chronic sinusitis…I had a previous doctor diagnose me with cough-variant asthma. But since Albuterol inhalers don’t really help for more than a few minutes at a time, if that, the reflux makes more sense. It only shows up when I’m in the throes or recovery stages of a sinus infection. Haven’t tried any pills for it yet, except cough drops. They help greatly in the throes of an attack, but it can get worse after the fact. Bladder leakage can be an issue although doing regular Kegels and Pilates/Yoga (while holding Kegels) really helps in that area. It helps my cough to avoid caffeine, peppermint, and of course alcohol–that’s a sure-fire cough trigger when I’m symptomatic. Not sure if Albuterol is a bronchodilator or not. I’ve tried homeopathic “Rumex Crispus” for dry cough, but unless I could completely stay off the coffee and menthol cough drops, it made things worse. Next I’ll search out a homeopathic remedy specifically for reflux, and possibly try accupuncture. Sinus hypertonic rinses and Flonase also seem to help, as long as I keep them up even when I’m not symptomatic.

  27. terri
    February 18th, 2012 | 10:54 pm

    To get rid of nighttime coughing, put a very thick coat of Vicks vapor on your feet and then put on a pair of socks. Does the trick for me!

  28. Stephanie
    March 11th, 2012 | 1:47 am

    I’ve been coughing for about four weeks. I decided today that if I’m not better by this coming Monday I’m going to the doctor. I went to Target today to get yet another over the counter medication for my cough….while talking to the pharmacist, she mentioned that it could be acid reflex!! I couldn’t believe my ears!! As soon as she said that I told her that I’ve had really bad pain in my stomach for about two weeks! I had no idea that a cough had anything to do with acid reflex!! I called my brother in law who has severe acid reflex and after a one conversation, I realized that is whats going on with me!! I’m not over weight, I excercise daily and eat healthy! But, I love coffee, wine and a lot of the foods that I shouldn’t be eating! I’m so thankful to all of you and your comments! I plan on taking a medication (over the counter) and moniter by diet, I’m so tired of coughing, I have a lot of mucus. I don’t have any coughing at night. It starts in the morning and continues all day long and into the evening! Thanks for all your helpful comments!
    Stephanie

  29. GPD
    March 24th, 2012 | 4:29 am

    Well after reading all the info on Gerd and acid reflux Im definatly going back to my doctors. Ive been on steroids now for 1 week on avolox (antibiotic for 20 days , advair for 2 weeks and he also gave me prilosec but im still coughing during the day with a dry cough, a cough that is not persistent but I have to clear my lungs every half hour. I cant believe that all the meds I am taking has nothing to do with acid reflux. Its pretty sad that I have to do this researtch and figure this out myself when I pay tons &tons of money to my insurance and these doctors dont even look beyond just taking Prilosec. I recall last year waking at night with acid coming up from my stomach and choking me. 3 weeks ago I thought I was having a heartattack my chest pain was so tight. So does anyone know what I can do in the mean while to prevent my coughing and tightness till I can get a endoscopy?

  30. Fran
    April 1st, 2012 | 2:54 pm

    Five yrs ago I too started coughing. Thinking it was from stress due to my spouse having cancer I ignored it some. Most doctors gave me a prescriptioin for an inhaler since I was a smoker and diagnosed me with Asthma! I tried allergy shots but quitin 2011. Last October I decided to agressively address this cough since no doctor could really tell me what it was from. I went to a Allergy/Asthma Specialist who tried various things. I used various inhalers, antihistimine nose sprays, Mucinex D, Sprivia inhaler, a nebulizer inhaler, had breathing test and one with medicationi to determine if I did have Asthma…and after all this the doctor said “his gut feeling is that I have a Reflux Cough”. I was also a good candidate for “Cough Varient Asthma”. I am currently taking allergy shots because I do have allergies. I am now taking the reins and self-medicating by….strickly following the Reflux Diet, eating tums, using Previcid, and cutting back on the caffine. I take Melitonin to sleep at night, plus use cough drops to ease the cough. Chewing gum also helps greatly in keeping the cough in control. Some days are good and some are not so good. I have only started this for 3 days but as time progresses I hope to see improvements. I am also trying to shed some pounds as I am overweight by about 30 lbs..I’m 73 yrs old and weigh 190 lbs, being 5′2″ is not a good weight for me. This site has been very helpful in reading other people’s responses and we all seem to have similar issues with this cough. I too gag at times.

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