Sneaky Symptoms: 15 Reasons Your Cough Could Be Due to Acid Reflux


You probably heard it countless times in songs or read it in many articles online and on print. The truth is what you don’t know can kill you, but what can kill you makes you stronger.

How is that saying related to acid reflux?

Let me tell you a secret: the symptoms of acid reflux are more than just heartburn or a burning sensation in your lower chest and middle abdomen. In fact, there is what experts like to call them “silent reflux” symptoms, which are often overlooked and misdiagnosed.

An example of this is a lingering cough. If you experience coughing that doesn’t seem to go away, then here are 15 reasons it could be a sign of acid reflux.

1. Medical Conditions 101: Defining Acid Reflux in a Nutshell

How much do you know about acid reflux? Before you proceed to the symptoms and treatments, it is important to know first what acid reflux is all about.

Acid reflux is a health-related condition characterized by burning pain around the lower chest area. Also known as heartburn or acid indigestion, acid reflux occurs when the acidic content from your stomach flows up into your esophagus.

If you think that it is just some acid, keep in mind that your stomach contains strong hydrochloric acid, which helps in the proper digestion of food and protects your stomach against bacteria and other undesirable elements. This explains why you experience a choking sensation and chest pain when the food from your stomach goes up to your esophagus.

If you experience this condition at least twice a week, then it could be due to gastroesophageal reflux disease or GERD.

2. Strength in Numbers: People Experience the Pain of Acid Reflux

Here’s the deal with acid reflux: it doesn’t discriminate.

According to the American College of Gastroenterology, more than 60 million Americans experience heartburn at least once a month, with more than 15 million getting heartburn symptoms everyday.

obesityAcid reflux knows no age, race, and gender. In fact, anyone can experience acid reflux, including yourself. Experts are unsure as to the exact cause of acid reflux, but most of them believe that lifestyle factors affect and will determine if you will experience this condition or not. These factors include:

  • Obesity or being overweight
  • Smoking
  • Poor eating habits
  • Lack of exercise
  • Low intake of dietary fiber
  • Use of medications, such as antidepressants and antihistamines

Let’s say you are guilty of these lifestyle factors. What happens next?

3. More Than Just Heartburn: Know the Symptoms of Acid Reflux

Heartburn is the main symptom of acid reflux. It takes in the form of burning sensations, which you will feel behind the breastbone area and it tends to worsen when you lie down. Aside from this, other symptoms you may have include:

  • Regurgitation, or the sour or bitter-tasting acid that goes into your throat or mouth from the esophagus
  • Vomiting
  • Chest or upper abdominal pain
  • Wheezing
  • Pain or difficulty in swallowing
  • Nausea
  • Bloating

weight lossDid you know that there are not-so-common symptoms too, known as silent reflux, which people often neglect? These no-so-common symptoms are:

  • Hiccups that don’t go away
  • Throat problems like hoarseness, soreness or laryngitis
  • Bad breath
  • Dysphagia, or the narrowing of esophagus, which creates a sensation that something is stuck in your throat
  • Sudden, unexplainable weight loss

Aside from this, there is one more silent reflux symptom you need to pay attention to: Coughing.

If you experience a dry, persistent cough that doesn’t seem to go away despite taking medicine, then it could be a sign of acid reflux. The following sections will discuss the relationship between cough and acid reflux, plus give you some tips on how to address it.

4. Hello, It’s Me: Diagnosing GERD with a Chronic Cough

Did you know that up to this day, there is no specific test that will determine whether you have acid reflux or not? The same goes with GERD coupled with chronic cough. Apparently, GERD does not show up in noninvasive radiologic tests like a barium swallow, the most commonly used diagnostic tool to check for GERD.

Still, there are ways available to help you check whether your cough is related to GERD or not. In this case, proton pump inhibitors or PPIs could help. This is a type of medication you need to take for three months to see if the symptoms will improve. If your body reacts to PPI positively, then you are likely to have GERD, and your cough could be related to it.

Aside from this, other tests available to check if your cough is GERD-related are the following:

  • 24 Hour pH Probe – This monitors the pH levels in your esophageal area.
  • MII-pH – This test also detects non-acid reflux.

If your doctor suspects you are a candidate of acid reflux based on chronic cough plus other symptoms, then they might order on of these diagnostic tests for you.

5. Differentiating GERD-Related Chronic Cough from Non-GERD-Related Chronic Cough

You’ve been coughing for weeks already and unfortunately, your cough medications don’t work. You also noticed that all the other symptoms for acid reflux are present, except for heartburn.

Is your cough related to GERD?

Here’s the deal: it is difficult to differentiate and determine whether the chronic cough you experienced is related to GERD or not. Tests like pH testing, upper endoscopy, and pH impedance testing could help in looking for evidence of GERD. On the other hand, the presence of any abnormal finding does not necessarily follow that you have GERD.

This is where a proton pump inhibitor or PPI therapy comes in, which is what you learned from the previous section. Read on to hear what the experts say.

6. Expert Theories: The Relationship Between Your Cough and Acid Reflux

As surprising as it sounds, your stubborn cough and acid reflux are two concepts that go together. Apparently, the mechanism showing the relationship between the two is still unclear up to this date. However, there are two theories from experts that may explain this mechanism.

These theories are as follows:

  • Reflux Theory – This is when the reflux arises above your esophagus and upper esophageal sphincter. The microdroplets land in the larynx or could enter the bronchial tree, which is a process called microaspiration. The causes cough as a protective mechanism against reflux.
  • Reflex Theory – The respiratory tract and digestive tract have embryologic origin. Because of the common origin between the two systems in your body, a bit of reflux in your esophagus could lead to esophagobronchial reflux, thereby causing the cough.

Aside from this, experts found out that coughing can cause acid reflux, which creates a vicious cycle of coughing, which doctors call the cough-reflux-cough cycle. In other words, it is a continuous vicious cycle. Unless you treat your acid reflux, you may never be able to get rid of your cough.

7. Finding Relief: The Link Between Your Chronic Cough and Acid Reflux

Chronic cough is a type of cough that does not improve after eight weeks. Some of the common causes of this condition are:

  • Asthma
  • Postnasal drip
  • Gastroesophageal reflux disease or GERD

This shows that GERD plays a crucial role in the development of chronic cough, thereby strengthening the cough-reflux-cough cycle. In fact, more than 25 percent of chronic cough cases are associated with GERD.

chest x-raysDoes this mean GERD is the cause of chronic cough? Not necessarily. However, it is difficult to separate the presence of both disorders from each other from their causative effect. Still, here are clues whether chronic cough is due to GERD:

  • Coughing without asthma or postnasal drip
  • Chest x-rays are normal despite your persistent coughing
  • A type of non-productive cough that happens during the day while you are in an upright position.
  • Persistent cough, even if other acid reflux symptoms are absent.

In case you are wondering about acid reflux, experts believe that reflux pH levels of four and above could lead to a chronic cough.

What about treatment? You might be wondering if there are available treatments for chronic cough as a result of acid reflux. The answer is yes. Whether you are looking for natural treatments or thinking of getting prescription drugs, the succeeding sections will help you find answers to your questions.

8. Work Against Gravity: Reflux Symptoms and Your Bodily Position

If you notice, reflux is more likely to happen if you are lying down where gravity is not opposing the urge to bring the acid back up into the esophagus. Consequently, the lack of gravity allows the refluxed liquid to travel up north and remain in your esophagus longer, thereby causing that chronic cough.

walk aroundThe good news is, you can work against gravity and prevent reflux from paying a visit. You can try the following techniques:

  • Put blocks to elevate the head of your bed by six to eight inches.
  • Sleep with your upper body on a wedge.
  • Do not lie down within two hours after meals.
  • Elevate your entire body, not just your head.
  • Walk around or finish some chores before you settle down and get your good night sleep.

The bottom line is to keep your esophagus above your stomach to counter the effects of gravity and keep food and stomach acid in place.

9. Dietary Decisions: Foods That Aggravate Your Acid Reflux Symptoms

Here’s the deal: what you eat could be eating you – and it’s not good. This means your diet plays an important role on whether or not acid reflux and cough will pay you an unwelcomed visit. At the same time, there are certain foods that could aggravate the symptoms, which you need to avoid.

alcoholic beveragesThey include, but are not limited to the following:

  • Spicy, fatty, and fried foods
  • Anything minty
  • Tomato-based foods, like pasta and pizza
  • Caffeinated drinks
  • Alcoholic beverages
  • Onion and garlic
  • Chocolate
  • Citrus fruits
  • Creamed foods

Every person is different, which means how your body reacts to food is different from others. Pay attention to your body’s cues and watch out for any adverse reactions. It would also help if you have a food tracker where you can list everything you ate that day and take note of how your body reacted to that specific food.

Moreover, here are foods that should be part of your diet:

  • Low-fat dairy products
  • Lean meat
  • Poultry
  • Whole grains
  • Fruits like apples, berries and lemons

In other words, the healthier your meals are, the lower the risk of meeting up with the symptoms of acid reflux. This leads us to the next valuable tip.

10. Eating Habits: Keep Your Acid Reflux Symptoms at Bay

Here’s the truth: it is not enough that you eat healthy and nutritious foods to combat the symptoms of acid reflux. How you eat is also crucial in helping minimize or preventing dry, persistent cough from taking over.

grillingTherefore, take note of the following eating habits:

  • Eat smaller, frequent meals instead of big ones three times a day.
  • Have dinner two to three hours before going to bed.
  • Stay away from foods that stimulate the production of acid.
  • Chew your food slowly and thoroughly.
  • Do not chew gum or candy to prevent the increase of amount of swallowed air that could worsen your dry cough condition or other symptoms of acid reflux.
  • Avoid bending after eating to prevent pressure on your abdominal area.
  • Instead of frying food, consider grilling, baking, boiling or broiling as a mode of cooking food.

These simple eating habits could spell a difference in helping you manage acid reflux and minimize the worsening of your cough. Take it one eating habit at a time. Adjusting your eating habits doesn’t happen overnight. You need to teach your body to accept these changes gradually.

11. Day by Day: Adapting Simple, Effective Lifestyle Changes to Fight Your Acid Reflux

Aside from what you eat, your lifestyle is also a deciding factor on whether acid reflux and dry cough will take over your body.

What does this mean?

It’s not just about what you eat and drink. How you live your life plays a crucial role in managing your symptoms of acid reflux and whether or not your persistent cough will stick around for good. Hence, make sure that you practice healthy lifestyle habits to keep the symptoms at bay.

Simple Lifestyle Changes to Reduce Your Acid Reflux

quit smokingHere are some effective ways to reduce the incidence of your acid reflux:

  • Quit smoking. Smoking relaxes your lower esophageal sphincter, which easily allows stomach acid to leak into your esophagus and cause pain and cough.
  • Loosen up. Wear loose-fitting clothes to prevent placing pressure on the abdomen area.
  • Lose extra weight. Excess weight adds extra pressure on your stomach, which can irritate acid reflux symptoms and cause stomach acid to go back up.

Lifestyle changes and altering your eating habits could help you manage acid reflux symptoms. Slowly, you are also able to treat dry, persistent cough.

Aside from lifestyle changes and natural treatment, is there a way you can treat cough, which may be due to acid reflux? Part of the treatment process is taking medications to minimize the symptoms of acid reflux and chronic cough. Keep reading to learn about the treatments available for this condition

12. Help is Here: Your Treatment Options for a Cough Due to Acid Reflux

You learned that proton pump inhibitors or PPIs are among the popular treatments against GERD. Aside from this, did you know that there are other medications involved, too?

Medications for a Cough Due to Acid Reflux

The following medications can help you with acid reflux:

  • Antacids to reduce stomach acids before they can rise up.
  • Foaming agents to help reduce stomach acid by delivering antacid in your system.
  • H2 blockers to decrease the production of acid in your stomach.
  • Prokinetics, which helps your stomach empty more quickly; however, this option is a last resort, because it comes with side effects like depression, anxiety and fatigue.

Fundoplication or Acid Reflux Surgery

What if you don’t respond well to medications? Let’s say your symptoms do not get better and that chronic cough is still there. This is when you should talk to your doctor to see if you can opt for a surgical procedure called fundoplication. Here’s how this procedure works:

  • It first repairs your hiatal hernia by tightening the opening in your diaphragm to prevent your stomach from bulging in an upward motion through the opening in the muscle wall.
  • It wraps the upper part of your stomach around the end of your esophagus using stitches. These stitches are able to create pressure at the end of the esophagus to prevent stomach acid from going up into the esophagus.

This procedure will take two to three hours while you are under general anesthesia. Make sure to consult your doctor first before subjecting yourself to this kind of serious and risky procedure.

13. Checking the Efficacy of Proton Pump Inhibitors or PPI Therapy

One of the most effective ways to determine whether your cough could be due to acid reflux is by going through PPI therapy. If your cough improves, then it means that constant barking is a sign of acid reflux, which could eventually lead to GERD if you are not too careful with your lifestyle.

The question now is does it work?

Older studies showed that up to 70 percent of patients responded well with PPI. However, new data suggested that patients who responded well with PPI therapy have other GERD symptoms, such as heartburn and regurgitation.

Does this mean PPI is not effective? Not necessarily; however, experts need to conduct further study to check the effects of this form of treatment to determine whether your chronic cough is because of GERD or not.

Here’s the question: what are the other treatments and developments available to treat GERD-related chronic cough? The next section will discuss more about that for you.

14. Gabapentin: The Latest Treatment for GERD-Related Cough

If there is one thing you should be thankful for, then you should thank the experts, researchers, and anyone in the medical field are constantly looking for treatments to help make your life easier. This includes treatment for GERD-related coughs.

Interestingly, experts looked into gabapentin and studied its effects on chronic cough, whether it is related to GERD or not.

In a study presented before the American College of Gastroenterology, experts directed participants to take low doses of gabapentin, initially 100 milligrams before bedtime. Gradually, subjected increased their gabapentin dosage to as much as 900 milligrams. The experts found out that approximately 75 percent of participants recorded at least 50 percent improvement in cough.

Despite the promising results, experts need to conduct further studies on the efficacy of gabapentin in treating chronic cough, regardless if it GERD- or non-GERD-related condition. After all, you need to treat acid reflux first before you completely eliminate your cough, which is what the experts are currently looking into.

15. Living with a Chronic Cough Due to Acid Reflux

At first, you might think that it is harmless, and cough syrup could do the trick. Then you realize that this cough doesn’t go away, despite religiously taking medications to help you improve your condition.

The truth is, you don’t have to subject yourself to this. If you notice persistent symptoms that don’t respond well to treatment, schedule a trip to the doctor to determine what is going on inside your body. This way, you can find appropriate treatments for your condition and be able to kiss them goodbye.

In the meantime, you can also employ lifestyle changes and adopt more efficient eating habits to minimize the symptoms until such a time that you and your doctor are able to figure out what is causing your chronic cough.

In Conclusion: Acid Reflux is No Joke

Here’s the truth: acid reflux is no laughing matter. Although it sounds harmless, it could take a toll in your normal routines, which could also affect your lifestyle. It could also have an impact on your self-confidence and make you feel more embarrassed when out with others.

work with your physicianYou don’t have to live this way. These 15 pointers about cough due to acid reflux only prove that you can do something about your condition. Adopt healthier lifestyle choices, pay attention to your body cues and reactions, and work with your physician closely to find the best solution to your problem.

The bottom line is to take action. Don’t let your chronic cough, acid reflux and other symptoms take over your body. You deserve better than that, so be proactive, so you can live a happy and healthy life.


One Comment/Review

  • Phil Atkin says:
    5 stars

    This article has put my mind at ease enormously and answered all the things that the doctor seems to have glossed over.
    Just saying that reflux can make you cough didn’t make sense – now it does.
    Thank you very much.

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