Reflux related cough anyone?

[cristiana]

Hi everyone

A couple of weeks ago, two weeks on from a bad cold, I was eating toast with a dry mouth and it irritated my throat and it triggered off a coughing fit.  Since then tomato ketchup and strawberry juice have had the same effect on two separate occasions.  

Since then I notice that I end up coughing during and after meals and I don't look forward to eating anymore, which is odd as normally I love my food. ?

The cough is dry, and as it is triggered when I eat (I don't cough at night) my doctor thinks I've got reflux and has prescribed a PPI for a week, to see if it helps.

She may be onto something as in the past I have woken up with the odd coughing fit but thought nothing of it - I gather that's a reflux symptom.  From time to time I've had heartburn. I am currently getting over glutening and also took some aspirin just before all this started which won't have helped I'm sure.

When I do cough I end up feeling very tight chested, as if the top part of my chest (not sure but think it's my lungs/respiratory tract) feels really itchy.

I have no problem exercising - oddly enough I had to run to the doctors today and didn't feel out of breath at all.  

I just wondered if this sensation sounds familiar to anyone and if they have found a quick way to get better, apart from PPIs.

Thanks!

[Ennis-TX]

12-14 years ago I ended up with Acid reflux that ate and caused a scar in my esophagus, then when ever it acted up or I ate anything it would trigger  coughing and I had a chronic cough for years til it healed. my family sorta helped coach me to ignore the cough since it was a fake urge to clear my throat.

My acid reflux was a freak issue to be honest >.< It was caused by caffine overdose that almost killed me and left my acid pumps constantly making acid and before I was put on PPI I was coughing up acid. Then I had a few years til the scar healed and cough urge stopped. I think you are probably catching yours before it causes too much scar tissue.
Over the years I have tapered back my dose to only taking Nexium once a day in the smallest dose and 1/4 my original zantac dosing....recently stopped after the national recall.

[trents]

It won't hurt to take the PPI short term to see if GERD is actually a problem you have. How often do you have heartburn? Reflux doesn't just happen at night when you lay down, by the way. That is a misconception. An endoscopy would be in order to check for esophagial erosion and hiatal hermia. Particularly since the coughing happens in conjunction with eating.

Since this all started when you had a cold, another possibility might be a occult sinus infection producing post nasal drip.

[cristiana]

41 minutes ago, Ennis_TX said:

12-14 years ago I ended up with Acid reflux that ate and caused a scar in my esophagus, then when ever it acted up or I ate anything it would trigger  coughing and I had a chronic cough for years til it healed. my family sorta helped coach me to ignore the cough since it was a fake urge to clear my throat.

My acid reflux was a freak issue to be honest >.< It was caused by caffine overdose that almost killed me and left my acid pumps constantly making acid and before I was put on PPI I was coughing up acid. Then I had a few years til the scar healed and cough urge stopped. I think you are probably catching yours before it causes too much scar tissue.
Over the years I have tapered back my dose to only taking Nexium once a day in the smallest dose and 1/4 my original zantac dosing....recently stopped after the national recall.

That's so interesting.  Yes, I'd been drinking a lot of coffee (I don't normally) before it happened.   I do hope you are right about catching it early.  And yes... I'm sure there is a coughing urge that needs to be suppressed - almost like the nerves become over sensitive, and to top it all the brain is also there looking for trouble!  Hyper vigilance strikes me if I ever have bad anxiety - perhaps this is the same sort of thing.  Thank you so much for your insight.

[cristiana]

35 minutes ago, trents said:

It won't hurt to take the PPI short term to see if GERD is actually a problem you have. How often do you have heartburn? Reflux doesn't just happen at night when you lay down, by the way. That is a misconception. An endoscopy would be in order to check for esophagial erosion and hiatal hermia. Particularly since the coughing happens in conjunction with eating.

Since this all started when you had a cold, another possibility might be a occult sinus infection producing post nasal drip.

Hi Trents

I get heartburn when I'm having a bad coeliac flare (cc) but that's always when my tum feels like it has battery acid in it, too.  I haven't felt that bad for a while, thankfully.  I've had two scopes, the last 18 months ago said it the esophagus and stomach were all normal but I guess there may have been damage since then.  If this PPI trick doesn't work quickly I'll ask for another.  Do you think it's possible to have serious damage in 18 months, with silent reflux (I call it that because I think if I have it at all, it has been without my knowing).

I like the idea of it being a cold though - that would make things so much easier!

C

[Wheatwacked]

My doctor put me on Lisinopril to control high blood pressure. In less than a month I got a tickly cough in the back of my throat that nothing would help. The cough woke me from sleep every two hours and caused an inguinal hernia and sleep deprivation.  Alka-Selzer works well for me for indigestion. Cold-Eze stops colds dead in their tracts. It's the antiviral effect of the zinc (an essential mineral RDA 8-40 mg/day). I have not had more than a sniffle for a few days, since 2004.

[Posterboy]

cristina,

eating low carb might help...they ferment pushing on the flap that leaks out stomach acid...eating fats with carbs...can delay stomach emptying leading to bloating...my nephew is dealing with this issue now...I prefer the H2 blockers because they seem to have less longer term effects....I have helped my friends with this issue...see chris kresser's site about "what everybody should know about stomach acid but doesnt'" series of article...3 of them if I remember correctly.. you can google for chris kresser and it should come up... here is the  link on "Management of GERD-Related Chronic Cough" research I have done for friends with the same issues... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3740808/

I hope this is helpful but it is not medical advise.

Posterboy,

 

[GFinDC]

If you are newly taking lisonopril it may be that causing the cough.  Lisonopril can cause coughing but it may dissipate over the course of several months.  At least it did for me.

[cristiana]

14 hours ago, Wheatwacked said:

My doctor put me on Lisinopril to control high blood pressure. In less than a month I got a tickly cough in the back of my throat that nothing would help. The cough woke me from sleep every two hours and caused an inguinal hernia and sleep deprivation.  Alka-Selzer works well for me for indigestion. Cold-Eze stops colds dead in their tracts. It's the antiviral effect of the zinc (an essential mineral RDA 8-40 mg/day). I have not had more than a sniffle for a few days, since 2004.

I don't take this but I do wonder if a hot lemon drink, which you can buy here in the UK - brand name Lemsip, but I'm having the supermarket's own brand - can dry the mucus in the throat and make the cough worse, as it happens to contain a decongestant. 

I like the idea of taking zinc, esp. as you haven't had more than a sniffle since 2004.  Thanks for the tip.

[cristiana]

8 hours ago, Posterboy said:

cristina,

eating low carb might help...they ferment pushing on the flap that leaks out stomach acid...eating fats with carbs...can delay stomach emptying leading to bloating...my nephew is dealing with this issue now...I prefer the H2 blockers because they seem to have less longer term effects....I have helped my friends with this issue...see chris kresser's site about "what everybody should know about stomach acid but doesnt'" series of article...3 of them if I remember correctly.. you can google for chris kresser and it should come up... here is the  link on "Management of GERD-Related Chronic Cough" research I have done for friends with the same issues... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3740808/

I hope this is helpful but it is not medical advise.

Posterboy,

 

Hi Posterboy

Thank you for this advice.  I shall follow it through... that's very helpful.  

It's so interesting that the article says:

"It is thought that it takes approximately 3 months for true GERD-related cough to improve because the nerves involved in the cough reflex take time to return to normal function."

I feel that my nerves are completely overreacting so I'm trying hard to resist the need to cough!

I have to say I did find Ranitidine which I think is an H2 blocker very good when I had gastritis type symptoms, which accompanied a coeliac flare a few years ago.  I didn't take much - 75-130 mg dose a day - but it really took the edge off things.  I tried to buy it in Boots The Chemist here but it's disappeared off the shelves, I think there has been a product recall for some rather worrying reasons, but hopefully that doesn't affect other H2 blockers.

I had to take Nexium Control for a short period when I was on battery acid antibiotics a few months back and it was very good, especially as I didn't have any rebound after a few days of taking it, but I think if I have to take stuff longer term until they find out what's going on I'll try to phase off a PPI onto an H2.  I must admit I got on with Ranitidine much better than omeprazole, that makes me feel quite sick and upsets my stomach in a different way.

Many thanks for all your help.

[cristiana]

H

6 hours ago, GFinDC said:

If you are newly taking lisonopril it may be that causing the cough.  Lisonopril can cause coughing but it may dissipate over the course of several months.  At least it did for me.

Thank you GFinDC. I must admit I don't take it but I am finding it a bit stressful not knowing exactly what is going on, so I can't think what it could be doing to my BP.  I do wonder if globus hystericus is perhaps an issue as I find when I don't focus on it too much it's not as bad.  Interesting I don't cough when I sleep.  

 

[cristiana]

This is so strange.  I didn't have a bad day cough wise, until my meal just now.

I'm only on day two of my Nexium trial so I guess it's early days yet. 

So I sat down to eat.  Three or four mouthfuls in there was this terrible internal itch behind my sternum.  It's like the tickle keeps moving south, I'm sure it started a bit further up when I first ate that piece of toast that started this annoying business off!  Does anyone know, is that where the esophagus ends?

I tried to resist the urge to cough, and managed mostly. It's not like it does any good anyway. 

I looked at the back of my throat earlier and I can see that again there are a very few white spots/patches near my tonsils so I'm wondering if a throat infection can go that far south.  I've had this really since my cold began early October.

My doctor doesn't want me to report back until Monday when the Nexium has had a chance to work but any words of wisdom would be so appreciated.  

 

[trents]

The common denominator in all this seems to be eating. Does this happen every time you eat something or does it seem to be associated with certain foods or certain textures?

Since it has been 18 months since your last upper GI I would look into another one. You may have a wound of some kind that is being irritated when food is swallowed. Not sure how this might connect with the cough but anatomical structures close together in the body often share nerve branches. I've noticed this with bowel and bladder, for instance. When one needs emptying the other often feels full as well.

[cristiana]

Trents, thanks so much for coming back to me. I'm panicking a bit over this so it's good to have someone to talk to!  I agree, I think an endoscopy is important.  I can't see my gastroenterologist until third week of November but hopefully having one by the end of the month will be OK.   I saw something really worrying on a website about a tickle in the throat triggered by eating being a typical symptom of early esophageal or lung ... well, you can image... and I don't want to go there but it isn't helping that I've seen that.   

I think when the sensation has been worse has been after some chips that had chilli on them, risotto with pepper and tonight - and so silly of me to eat such a thing at this time - Chicken Kiev.     

Breakfast and lunch are much easier than the evening meal for some reason.  That's always the most problematic meal.  I think it isn't helping that I'm actually now dreading that particular meal the most.

Being a lifelong hypochondriac isn't helping one iota.  

[trents]

From your own admission, dry (toast and chips) and spicy foods seem to trigger this cough reaction and the "tickle" behind the sternum. I'm certainly no doctor but that suggests to me there is something being irritated when you eat these things. If that irritated area is on or near epiglottis (the flapper valve that closes off the windpipe when you swallow) then that could be causing the cough, mimicking what happens when food starts to, as we say, "go down the wrong way." If the epiglottis itself is swollen it may be reacting to the dry, spicy food or it may not be sealing well. Just brainstorming here.

[cristiana]

Trents... that's such an interesting thought.  In fact the theory about the irritation being near the epiglottis and mimicking the "I've to got cough this up" sensation makes so much sense.

When I first coughed and spluttered over dry toast, strawberry juice and tomato ketchup, it was in that region of the upper throat, suggesting that's where the irritation was at the start.  Two weeks post a really nasty cold, and around the time I saw some white patches and spots at the back of my throat.   I guess the subsequent throat clearing can't have helped and possibly the infection - if that what it is - may have also moved a bit further down since then.

My appointment can't come quick enough.  I'm afraid I'm not a very patient patient!  

Thank you so much for your replies today.  It's been a real blessing as this evening I'm home alone with the kids and I can't talk to them about this.

[Wheatwacked]

C

On 11/7/2019 at 1:55 PM, cristiana said:

I can't see my gastroenterologist until third week of November

I did not realize the cough connection until after my doctor fired me and since even the lisinopril and amlodipine together did not affect my BP I realized that meds were not the solution. So I started Dr. Fuhrman's 6 week plan and after only 3 weeks my BP dropped. I cheat a lot because I am anorexic and have no patience for food, and I know my food intake was less needed, but it still worked and my appetite has tripled and other good stuff. I feel that you would benefit greatly while you wait for the doctor. It is designed to heal your gut. He says his is the only diet that actually has all the essentials in sufficient quantity.

 

[cristiana]

4 hours ago, Wheatwacked said:

C

I did not realize the cough connection until after my doctor fired me and since even the lisinopril and amlodipine together did not affect my BP I realized that meds were not the solution. So I started Dr. Fuhrman's 6 week plan and after only 3 weeks my BP dropped. I cheat a lot because I am anorexic and have no patience for food, and I know my food intake was less needed, but it still worked and my appetite has tripled and other good stuff. I feel that you would benefit greatly while you wait for the doctor. It is designed to heal your gut. He says his is the only diet that actually has all the essentials in sufficient quantity.

 

Thank you so much for this.  I've not heard about that plan so will look it up.  I do need to try to eat better myself, and my TTG hasn't been so good since a holiday in France where there was a lot of cc.  As I don't feel like eating vast amounts I think this will help immensely.  

[Mariekt]

I developed a chronic cough over a year ago. Went to an ENT and he thought I had acid reflux but esophaogram was negative for it. The cough continued as did the pressure in my chest that prevented me from lying down flat to sleep. In August I got a sharp pain in my right ribcage that stayed there for days. Went to my doctor to get it checked out. He ordered a chest x-ray which showed I had so much fluid in the right side of my chest that it had almost completely collapsed my lung. I ended up in th ER the next day hardly able to breath. Had to have the fluid drained then but it continues to accumulate in the right side of my chest, which requires me to go to the hospital every 3-4 weeks to get it drained while doctors try to figure out what's causing it. I believe it is caused by getting cross contaminated with gluten when I've eaten out. I have eaten at home for the past 3 weeks and also eliminated all grains from my diet and fluid accumulation seems to be slowing down. I urge you to get a chest x-ray right away to see if you might have fluid in your chest. My cough went away as soon as the fluid was drained in August.  Good luck!

Edited January 7, 2020 by Mariekt
Typo

[cristiana]

Thank you so much for this, I have been wondering why my own doctors haven't ordered one as it has now been over two months that I've had this discomfort, itchy throat and occasional coughing fit.  Your message has given me the confidence to request one today - thank you so much.  And I really hope you will have all the answers you need soon.

C

[Mariekt]

15 hours ago, cristiana said:

Thank you so much for this, I have been wondering why my own doctors haven't ordered one as it has now been over two months that I've had this discomfort, itchy throat and occasional coughing fit.  Your message has given me the confidence to request one today - thank you so much.  And I really hope you will have all the answers you need soon.

C

Glad you are going to ask to get a chest x-ray. They are such an inexpensive way to see what's going on in your chest. I think mine cost my insurance $36, and uncovered serious problems, including the fluid in my chest and a mass in my right lung. The mass has since shrunk and biopsy was negative for cancer. I would encourage you to see an allergy/immunology doctor, too. I am seeing one now and through blood tests she discovered that my T and B cells are very low and not functioning normally. Now she is going to do genetic and autoimmune tests. All my other numerous tests and biopsies showed nothing and left my doctors perplexed and still searching for cancer but nothing could be found. I asked my allergy/immunology doctor if all my issues could be due to malnutrition and she said yes. As you know, malnutrition is common in those with Celiac. I wish you the best on your journey. Keep me posted!

[knitty kitty]

On 1/7/2020 at 1:03 AM, Mariekt said:

I developed a chronic cough over a year ago. Went to an ENT and he thought I had acid reflux but esophaogram was negative for it. The cough continued as did the pressure in my chest that prevented me from lying down flat to sleep. In August I got a sharp pain in my right ribcage that stayed there for days. Went to my doctor to get it checked out. He ordered a chest x-ray which showed I had so much fluid in the right side of my chest that it had almost completely collapsed my lung. I ended up in th ER the next day hardly able to breath. Had to have the fluid drained then but it continues to accumulate in the right side of my chest, which requires me to go to the hospital every 3-4 weeks to get it drained while doctors try to figure out what's causing it. I believe it is caused by getting cross contaminated with gluten when I've eaten out. I have eaten at home for the past 3 weeks and also eliminated all grains from my diet and fluid accumulation seems to be slowing down. I urge you to get a chest x-ray right away to see if you might have fluid in your chest. My cough went away as soon as the fluid was drained in August.  Good luck!

Thiamine deficiency will cause a collection of fluid in the lungs.  

Thiamine is necessary for the proper growth and function of T and B cells.  

Thiamine deficiency will cause a cough.  The vagus nerve is affected by thiamine deficiency, becoming hypersensitive and coughing is easily triggered.  The vagus nerve also controls acid production, the sphincter muscles that keep acid in the stomach becomes loose hence gerd, peristaltic action is slowed.  

Take your thiamine!  Doctors don't recognize vitamin deficiencies any more!   

Celiac Disease causes malabsorption which results in malnutrition.  Checking for vitamin and mineral deficiencies is part of follow up care of Celiacs.  Please check with your doctor!!! 

[cristiana]

7 hours ago, Mariekt said:

Glad you are going to ask to get a chest x-ray. They are such an inexpensive way to see what's going on in your chest. I think mine cost my insurance $36, and uncovered serious problems, including the fluid in my chest and a mass in my right lung. The mass has since shrunk and biopsy was negative for cancer. I would encourage you to see an allergy/immunology doctor, too. I am seeing one now and through blood tests she discovered that my T and B cells are very low and not functioning normally. Now she is going to do genetic and autoimmune tests. All my other numerous tests and biopsies showed nothing and left my doctors perplexed and still searching for cancer but nothing could be found. I asked my allergy/immunology doctor if all my issues could be due to malnutrition and she said yes. As you know, malnutrition is common in those with Celiac. I wish you the best on your journey. Keep me posted!

Thank you so much ... will do.  I've had the X-ray but because it was construed as non-urgent I'll have a couple of weeks to wait.  But it is a relief to have just got it out of the way, I've been thinking about having one for many weeks but kept hoping the symptoms would go.   

It sounds as if you have been on a massive journey with your health.  My friend who has ulcerative collitus has also had a pleural effusion and it took a good while to ascertain it wasn't caused by cancer.   She would have massive vitamin deficiencies in my view as she has had a very restrictive diet in years.   I have so many weird symptoms that now I think may be due to malnutrition.  I need to improve my diet but I think in the short term I'm going to have to look at some really good supplementation.

[cristiana]

1 hour ago, knitty kitty said:

Thiamine deficiency will cause a collection of fluid in the lungs.  

Thiamine is necessary for the proper growth and function of T and B cells.  

Thiamine deficiency will cause a cough.  The vagus nerve is affected by thiamine deficiency, becoming hypersensitive and coughing is easily triggered.  The vagus nerve also controls acid production, the sphincter muscles that keep acid in the stomach becomes loose hence gerd, peristaltic action is slowed.  

Take your thiamine!  Doctors don't recognize vitamin deficiencies any more!   

Celiac Disease causes malabsorption which results in malnutrition.  Checking for vitamin and mineral deficiencies is part of follow up care of Celiacs.  Please check with your doctor!!! 

Knitty Kitty.... this is so so interesting.

Some of my blood tests are suggestive of deficiencies.  Pre-coeliac diagnosis I was eating bread and breakfast cereals with lots of added vitamins and sometimes iron.  Now those same gluten-free foods that I eat have nothing added.   

There is a Spanish study that shows women with chronic coughs improved when their iron levels were improved.  My iron is on the floor but I'm not allowed to supplement because I have high hemoglobin, but at least I can improve my thiamine.  Thank you so much!  

[Ennis-TX]

1 hour ago, cristiana said:

Knitty Kitty.... this is so so interesting.

Some of my blood tests are suggestive of deficiencies.  Pre-coeliac diagnosis I was eating bread and breakfast cereals with lots of added vitamins and sometimes iron.  Now those same gluten-free foods that I eat have nothing added.   

There is a Spanish study that shows women with chronic coughs improved when their iron levels were improved.  My iron is on the floor but I'm not allowed to supplement because I have high hemoglobin, but at least I can improve my thiamine.  Thank you so much!  

My iron stayed low for years even eating foods high in iron, >.< I did have a constant drain with UC but it still only improved when I started taking Vitamin C with meals