Acid Reflux Cough LPR

Chronic Cough and Acid Reflux

Cindy from Houston sent us this question: “Starting almost 6 months ago, I developed a persistent cough and at times had difficulty catching my breath. This would happen during day and night. I first was diagnosed with reflux. I then had an upper GI and told no reflux, but chronic inflammation, but was prescribed generic Protonix which caused me to cough up creamy white substance. Three months into this current ordeal, I was diagnosed with pertussis verified by 3 different types of immune globulin. I continued having pain and coughing specifically in vocal cord area. I saw an otolaryngologist who diagnosed paradoxical vocal cord motion disorder. He said to continue treating for reflux, taking Prilosec and Pepcid as needed. I didn’t feel I needed them and only took either maybe once or twice a week. 5 months into this, I had followed up with GI provider. I had been having continued inflammation in my throat, roof of mouth, inflamed tongue, uvula, and deep in throat. This very disturbing discomfort and pain seemed to move around and caused a very thick clear, tenacious, stringy mucus/substance, almost consistency of jelly at times.  I didn’t know if this was from the continued inflammatory response from pertussis or gastric reflux. I asked the GI doctor and he prescribed Omeprazole 20 mg to be taken before twice each day before morning meal and noon meal and also famotidine 40 mg every bedtime. He said to take this all for a month. I thought too much and took one Prilosec in morning and half of famotidine (20 mg) at bedtime. I did this faithfully for two weeks but then I actually did start having reflux up into throat when sleeping, first time this had happened, and so I figured the meds were making things worse for me. I also was having stomach/abdominal pains, generalized bloating, nausea, no appetite and slowed motility causing constipation and feeling like I was blocked up. I quit taking the Prilosec but continued the famotidine at 20 mg at bedtime for few nights and then now have cut down to 10 mg of famotidine at night and taking Mylanta as needed instead. My problem is I still am having trouble with my GI tract not working. It’s been about two weeks since I stopped Prilosec. I want to quit famotidine too and just take Mylanta as needed. I was so bloated up yesterday and seems like bowels not working. I had a ruptured diverticula un my early 40s with partial colectomy and colostomy and subsequent reversal. I have been careful with diet since but taking this Prilosec has seemed to really mess up my digestion and I hope I can get this reversed. I usually take one Metamucil capsule each day for bowel health, but I’m not sure if that is helping or hurting right now while trying to get over effects of Prilosec”.

Dear Cindy,

Cough has many causes and acid reflux is one of them. The diagnosis of acid reflux may be challenging. However, a competent acid reflux specialist in Houston can help you get the answers you need. Indeed, a certain level of expertise is required to properly evaluate and effectively manage patients with chronic cough. If acid reflux is the cause of your symptoms, several effective solutions are available to help alleviate your symptoms and improve your quality of life.

At Houston Heartburn and Reflux Center, we offer state of the art acid reflux testing. We strongly believe that patient testing is the first important step towards cure. We aim at confidently confirming the diagnosis of acid reflux and staging GERD. Accordingly, an effective and safe solution is tailored to alleviate acid reflux related symptoms like cough, sore throat, and globus.

Blindly prescribing medications at different dosages is not a practice we advocate for treatment of cough related acid reflux. PPIs reduce gastric acid secretion, but these medications do not stop reflux. Heartburn may respond to PPIs but cough is less likely to resolve unless you re-establish the anti-reflux barrier.

The most effective and reliable solution to re-establishing the acid reflux barrier is hiatal hernia repair and Nissen fundoplication. This minimally invasive procedure has a very high success rate and low complication rate. When properly performed, acid reflux patients report a very high satisfaction rate.