A stubborn cough can be frustrating, especially when it seems to have no clear cause. Coughing after meals, at night, or alongside heartburn may be a sign of gastroesophageal reflux disease (GERD).
GERD is a chronic condition where stomach acid flows back into the esophagus. The esophagus is the tube connecting your mouth to your stomach.
There is a ring of muscle at the bottom of the esophagus called the lower esophageal sphincter (LES). Its job is to keep stomach contents where they belong. If it doesn’t close properly or weakens over time, acid reflux occurs.
Repeated exposure to stomach acid can irritate the esophagus, leading to symptoms like:
But GERD doesn’t only cause classic heartburn symptoms. Sometimes, it manifests in unexpected ways, such as a chronic cough.
A GERD-related cough happens when stomach acid reaches the throat or airways. This triggers irritation and inflammation. This can happen in two ways:
1. Direct irritation
Stomach acid and digestive enzymes travel up the esophagus and into the throat, irritating the vocal cords and airway. This irritation can cause a persistent dry cough, hoarseness, and even a sore throat.
2. Reflex mechanism
Even when acid doesn’t reach the throat, it can stimulate nerves in the esophagus that trigger the cough reflex. This means GERD can cause coughing even if you don’t feel heartburn. As such, people with chronic GERD-related cough often don’t associate it with acid reflux. That’s because they don’t experience classic heartburn symptoms.
Certain features suggest GERD is causing a chronic cough, especially if you have a history of GERD, heartburn, or acid reflux. Other symptoms include:
Since many conditions can cause chronic cough, other causes must be ruled out first.
If you have classic symptoms like heartburn or regurgitation, or if your cough worsens after eating or when lying down, your doctor may suspect it.
They may order a 24-hour esophageal pH test to measure how often acid enters the esophagus. A small probe is placed in the esophagus to track acid levels over a full day. This helps pinpoint if your cough is linked to reflux.
An upper endoscopy may be performed in which a thin, flexible camera is inserted down the throat to look for signs of esophageal acid damage.
In order to manage GERD-related cough, your underlying acid reflux must be treated.
Simple adjustments can significantly reduce GERD symptoms and coughing, including:
If these types of lifestyle changes aren’t enough, medications can help.
Your doctor may recommend a trial of proton pump inhibitors (PPIs) for 8 weeks to see if your cough improves. PPIs, like omeprazole, are stronger acid reducers that heal esophageal damage.
If GERD symptoms are severe and persistent despite treatment, surgical procedures may be recommended.
A gastroenterologist (GI doctor) is a medical specialist who diagnoses and treats digestive system disorders. This includes GERD-related cough. If you have a persistent cough, seeing a doctor to understand the cause is essential.
Don’t continue to wonder if GERD can cause coughing – schedule an appointment today!
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