What Is Acid Reflux Disease
Digestion begins in the mouth with chewing and continues when the food is swallowed. The stomach contains a mixture of acid, bile and pepsin, which further breaks down the food before it exits into the intestine. A small ring-shaped muscle called the lower esophageal sphincter (LES) opens to allow the food to pass through to the stomach, then closes to prevent the stomach contents from re-entering the esophagus. The LES may become weak and fail to close completely, or certain foods or medications may lower the pressure in the stomach and the LES opens inappropriately. The stomach contents then wash back into the esophagus and cause the burning pain typically associated with acid reflux disease.
Stomach fluid is acidic and irritates the esophagus. Common symptoms of acid reflux disease are heartburn, chest pain, wheezing, difficulty swallowing or a sour taste. Cough is a common symptom but it is often not recognized as being related to acid reflux. Cough can accompany heartburn or chest pain, but some people may experience cough without the other symptoms.
Why Acid Reflux Causes Coughing
Acid reflux may cause cough in several ways. There may be only a small amount of stomach fluid regurgitated into the esophagus, not enough to cause a burning sensation but enough to cause a cough. At other times, the fluid is mostly bile, which does not burn but stimulates cough. Sometimes such an excessive amount of stomach fluid refluxes that it spills over into the lungs, causing persistent cough and potentially leading to pneumonia or bronchitis. Cough may also be caused by heartburn medications.
Diagnosis and Treatment
Acid reflux-associated cough is one of the most common causes of chronic cough but it can be difficult to diagnose. Most people do not associate coughing to acid reflux disease, especially if they are not experiencing heartburn. Your doctor can administer a simple breathing test to determine whether a persistent cough is due to acid reflux or another condition. Cough suppressants used for coughs due to colds are ineffective. Treatments for acid reflux disease, such as antacids, nitrates, beta-blockers or proton pump inhibitors, are also effective for treating acid reflux cough. Overuse of antacids, however, may worsen cough. Occasional use of antacids helps neutralize excess stomach acid, but overuse may cause the stomach to produce greater amounts of fluid, which then regurgitates into the esophagus.