Acid Reflux Cough: 26 Guaranteed Facts Exposed

Heartburn is not the only important symptom of acid reflux.

There are many more situations to consider, even if we must say that not all symptoms occur with the same frequency among the people.

Some symptoms are more frequent, others are not even detected.

Things may be complicated by the presence of different diseases, and a proper diagnosis is not always simple.

Now, we want to focus the attention on acid reflux cough.

This is one of the most common symptoms and, even though it’s not always related to reflux disease, this association is more frequent than it may seem.

Cough is just one of the many pulmonary manifestations of gastroesophageal reflux disease.

The list also includes throat irritation, postnasal drip and hoarseness, recurrent cough, chest congestion and lung inflammation leading to asthma and/or bronchitis or even pneumonia.

GERD is often related to the presence of a persistent cough, and in such cases, things are more complicated.

When it comes to the relationship between reflux and cough, there are several important things to consider.

Let’s get started with some data about this symptom.

Acid Reflux Cough

Acid Reflux Cough: A Common Symptom

According to several findings, GERD is one of the most common causes of chronic cough.

More precisely, it has been noted that at least 25% of all cases of chronic cough are caused by gastroesophageal reflux disease.

There are even some pieces of evidence reporting that 40% of cases of chronic cough are due to GERD.

These data reveal that the cough has to be considered as one of the most relevant signs of reflux and needs a prompt investigation.

In addition, there other two equally important things to consider:

Different reasons for cough
Even if GERD is the most common cause of chronic cough, there’s another fact. Cough can be caused by both acidic and not acidic reflux. In this case, the acidity is not a factor, meaning that cough can be present independently on the specific characteristics of the refluxate.
Different symptoms
In the majority of cases, people with cough from reflux do not present the same symptoms that can be reported by other reflux sufferers who, on the contrary, do not have a cough.

This second aspect is very important: the cough is a sign of something different, in many cases, and deserves to be investigated better.

Acid reflux cough symptoms

We want to dive a bit deeper and investigate how this symptom manifests itself within the reflux disease.

Just like to present “symptoms” of a symptom of acid reflux.

This is important because, as we stated at the beginning, the cough may alter the profile of symptoms that commonly occur in reflux disease.

That’s why we want to group the people in two categories.

People With Typical GERD Symptoms
In these individuals, the main problems are usually heartburn and regurgitation. Cough is present, but it’s usually a secondary issue. In these cases, the diagnosis is less complicated, just because of the predominance of common symptoms of reflux disease, and in particular heartburn.
People With Cough Only As A Symptom
In these individuals, the only cough is present, meaning that they do not have symptoms of reflux or GERD. However, just because of the close relationship between these two conditions, physicians are trained to consider GERD as a potential cause for cough, despite the lack of GERD symptoms. .

This second situation is challenging because the reflux disease could be the root cause of cough, however, the person may not report typical reflux symptoms.

The most common fact (in these cases) is the absence of heartburn.

A very important thing to remember is that the group of people with the only cough as a symptom tends not to respond well to standard GERD therapy.

Coughing up stomach acid

This is quite an important thing to consider.

In fact, despite the majority of people who suffer from GERD have acidic reflux, the cough can also be caused by non-acidic or weakly acidic reflux.

Scientists don’t completely agree on that, however, it seems that it’ possible for the reflux to have a pH above 4, and still cause cough.

In particular, pepsin can be found in the bronchial tree of people with laryngopharyngeal reflux.

When this happens, this enzyme is able to cause injury even at a pH above 4.

The takeaway is that not only stomach acid is a reason for the cough to occur.

In many cases, non-acid and /or weakly acid reflux can determine this symptom.

And, under such circumstances, things may be more difficult to reveal.

Acid reflux and coughing up mucus

When a person is coughing up mucus, there may be several explanations.

Talking about reflux and cough with mucus, one of the reasons can be the presence of LPR (laryngopharyngeal reflux).

We’ll talk a bit more about that later, for the moment we just want to point out that some frequently common symptoms are hoarseness, sore throat, coughing, excess throat mucus, and globus.

The presence of mucus can possibly guide you towards the discovery of LPR, even if this is not a certainty.

However, this may be possible just because the dry cough is more typical, in the case of association with reflux.

Acid reflux dry cough

A dry cough is typical in the case of reflux.

In fact, there is a specific correlation between the presence of cough during the night, reflux and dry cough.

People with a persistent dry cough are more likely to show an increased sensitivity of the cough reflex.

This further impairs their quality of life, because such increased sensitivity acts as a trigger that determines the increased frequency of episodes.

Acid reflux cough after eating

Cough can be often present after a meal, and this is a sign of correlation with reflux disease.

Especially if that occurs for a long time.

The symptom may be more difficult to bear when present during the night.

This fact is unfortunately common and it is important because in some cases it allows a better understanding of the relationship between reflux disease and cough.

Acid reflux cough at night

This particular condition is closely related to the presence of GERD.

In fact, nocturnal cough is also the result of body position.

We know that lying down on the right side is a factor that promotes reflux, and in such cases, the position of the body is the key.

When it comes to cough, the side on which to sleep has less importance.

As we’ve considered before when a cough is present during the night, and after a meal, this is a sign of a strong correlation with reflux.

Acid Reflux And Coughing: Why Does This Happen?

There are at least two different mechanisms that explain why acid reflux could cause cough (and chronic cough, with the time).

The first one is called “The Reflux Theory“.

We report the official explanation of this mechanism directly from the original source:

#1) The Reflux Theory
Reflux rises above the esophagus and upper esophageal sphincter, resulting in microaspiration as microdroplets land in the larynx or occasionally enter the bronchial tree, directly causing cough as a protective mechanism against reflux.

By reading this text, we have a better idea of why this does happen.

According to this mechanism, the stomach content reaches the highest part of the esophagus and then enters the larynx. Cough is then a reaction of defense against such an “intrusion”.

But there’s another possible explanation.

A bit harder to figure out, but able to answer even better to the question: how acid reflux can cause cough?

Can acid reflux cause cough?

There is a second possible reason why acid reflux could lead to a cough.

It’s called “The Reflex Theory“.

We report the official explanation of this mechanism from the same source we referred to before.

#2) The Reflex Theory
Because of the common embryologic origin of the respiratory tract and the digestive tract, a little bit of reflux in the esophagus can lead to an esophagobronchial reflex that causes cough.

In this case, acid reflux could cause cough because of the common origin of respiratory and digestive tracts.

However, there’s another fact to consider.

Often overlooked, but important.

Can cough cause acid reflux?

The same source we mentioned for the two mechanisms presented above, also presents another interesting finding.

In fact, there is evidence that cough can lead to reflux.

In other words, it has been noticed that coughing leads to imbalances of the abdominal pressure. As a direct consequence, stomach content is pushed upwards and chances of reflux increase.

In the case of other concomitant factors that may promote reflux (dietary habits, wrong lifestyles, etc.) reflux is much more likely to occur.

When this happens, the presence of cough + reflux leads to a cycle of cough (also called “cough-reflux-cough” cycle).

There is a time window of approx. 2 minutes between reflux episodes and subsequent (induced) cough.

LPR Cough

Laryngopharyngeal reflux (LPR) is a complex of symptoms caused by the backflow of gastric contents into the larynx, pharynx, nasopharynx, sinuses and even to the middle ear space.

This condition deserves specific attention, however, we want to point out relationships between LPR and cough.

In fact, there are many symptoms like:

  • chronic cough
  • hoarseness
  • throat clearing
  • laryngitis
  • globus pharyngeus
  • swallowing disturbances
  • postnasal drip

The reason for all the above-listed symptoms is the presence of refluxate (gastric content) inside the airways.

This determines irritation and cough is a defense system.

LPR is particularly important because of its serious complications.

Among them, there is the scarring of the voice box and windpipe and an increased risk of developing esophageal cancer.

Once again, cough is just a symptom: in order for a treatment to be really effective, it must target the root cause.

To this end, home remedies are best.

Even because of the possible transformation of cough into a chronic symptom.

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GERD Chronic Cough

When the cough persists for a long time, generally more than 8 weeks, we can talk about “chronic cough”.

This is a more serious condition, another reason for you to start working on the root cause of the disease ASAP, with natural remedies and the proper lifestyle/eating habits.

In general terms, people with chronic cough are also much more sensitive to airway stimuli, as shown by the image below.

Even if acid reflux plays an important role in determining chronic cough even if it’s not well-known why some people present many more symptoms than others.

Whatever the case, it has been observed that there are two main factors to consider.

  • The first one is the presence of a larger volume of the refluxate
  • The other one is the oesophageal exposure to reflux for a longer period of time

In addition, findings suggest that the acidity of the refluxate seems to be less relevant.

This means that even in the case of non-acidic and weakly acidic refluxate a chronic cough can occur.

This has very important and direct consequences when it comes to treatments.

In fact, most patients with chronic cough tend not to benefit from acid inhibitory treatment.

In other words, don’t take any prescription medications and antacids to try getting rid of chronic cough.

The way to win your battle against the condition is to work with natural, home remedies you can prepare easily right now.

Treatment for acid reflux cough

Before to present some good natural solutions to the root cause of acid reflux cough, we want to list what the conventional medicine suggests.

This is the updated list of recommendations, to follow in their precise order.

We report them directly from the CHEST Guideline and Expert Panel Report.

Phase 1
In adult patients with chronic cough, the cough should be managed according to a published management guideline that initially considers the most common potential etiologies as well as symptomatic gastroesophageal reflux. In other words, recognizing the real, root cause of cough is essential, and not only in the cases of concomitant presence of reflux.
Phase 2
In adult patients with chronic cough suspected to be due to reflux-cough syndrome, the treatment should include: a diet modification to promote weight loss in overweight or obese patients; head of the bed elevation and avoiding meals within 3 hours of bedtime; in patients who report heartburn and regurgitation, proton pump inhibitors (PPIs), H2-receptor antagonists, alginate, or antacid therapy sufficient to control these symptoms.
Phase 3
In adult patients with suspected chronic cough due to reflux-cough syndrome, but without heartburn or regurgitation, PPI therapy alone is NOT recommended, because it is unlikely to be effective in resolving the cough.

Please, not such an important assumption: when reflux is involved, treatment with chemical drugs and prescription medications is not recommended.

Instead, using home remedies and the promotion of a proper lifestyle is essential.

Phase 4
In adult patients with chronic cough potentially due to reflux-cough syndrome who are refractory to a 3-month trial of medical antireflux therapy and are being evaluated for surgical management (antireflux or bariatric), or in whom there is strong clinical suspicion warranting diagnostic testing for gastroesophageal reflux, the suggestion is they undergo esophageal manometry and pH-metry with conventional methodology
Phase 5
In adult patients with chronic cough and a major motility disorder, and/or normal acid exposure time in the distal esophagus, antireflux surgery is not recommended.
Phase 6
In adult patients with chronic cough, adequate peristalsis, and abnormal esophageal acid exposure determined by pH-metry in whom medical therapy has failed, guidelines recommend antireflux (or bariatric when appropriate) surgery for presumed reflux-cough syndrome.

These are the recommendations from conventional medicine nowadays.

However, working on acid reflux cough with natural remedies makes life a lot easier and better.

Home Remedy For Acid Reflux Cough

Cough is a symptom, and this is the reason why you must treat the disease as a whole.

In fact, effective treatment can’t simply target one or more symptoms. It’ necessary to act on the root causes of your condition, to experience consistent benefits over time.

Acid reflux cough is not an exception.

To be honest, there is not a single suggestion we can make to treat acid reflux cough.

It’ much better to start avoiding spicy and fatty foods, as well as a heavy meal. At the same time, you should integrate your diet with some highly beneficial natural products, such as ginger, or turmeric, or honey.

Talking about honey, it is often considered to be an excellent cough remedy, and it certainly is an excellent natural product to use in case of reflux.

So, what about mixing things? Could be honey good for treating acid reflux cough?

According to some studies, the answer to this question is so-so.

In fact, it seems that, at least for acute cough in children, there is no big evidence of benefits, even if some benefits are reported.

In other words, honey can be effective, and we can consider it like a double-treatment for cough and reflux.

But it’s important to work on lifestyle habits, especially for avoiding to sleep in the right position, during the night.

Heartburn and cough are frequent at night, while LPR cough is more often during the day (another possible way to distinguish the two conditions).

We recommend checking this more comprehensive strategy for getting rid of cough as well as other symptoms of reflux.

It’s a 5-Step Holistic Approach that takes care of all aspects and features of reflux. With the proper implementation of what’s found inside, cough, as well as other symptoms, could be greatly reduced in a short time.

Conclusions

Acid reflux cough deserves the greatest attention.

There are at least 26 takeaways to remember.

The list is below.

Takeaways
#1) Cough is just one of the many pulmonary manifestations of gastroesophageal reflux disease.

#2) GERD is often related to the presence of a persistent cough.

#3) At least 25% of all cases of chronic cough are caused by gastroesophageal reflux disease.

#4) Cough can be caused by both acidic and not acidic reflux.

#5) People with cough from reflux do not present the same symptoms that can be reported by other reflux sufferers who, on the contrary, do not have a cough.

#6) In some individuals, the main problems are usually heartburn and regurgitation; cough is present, but it’s usually a secondary issue.

#7) In other individuals, the only cough is present, meaning that they do not have symptoms of reflux or GERD.

#8) The presence of mucus can possibly guide you towards the discovery of LPR, even if this is not a certainty.

#9) A dry cough is typical in the case of reflux.

#10) People with a persistent dry cough are more likely to show an increased sensitivity of the cough reflex.

#11) Cough can be often present after a meal, and this is a sign of correlation with reflux disease.

#12) Acid reflux cough at night is another typical situation.

#13) The Reflux Theory: the stomach content reaches the highest part of the esophagus and then enters the larynx, and cough is a reaction of defense against such an “intrusion”.

#14) The Reflex Theory: acid reflux could cause cough because of the common origin of respiratory and digestive tracts.

#15) There is evidence that cough can lead to reflux,

#16) When this happens, the presence of cough + reflux leads to a cycle of cough (also called “cough-reflux-cough” cycle).

#17) LPR cough is generally more serious.

#18) People with chronic cough are also much more sensitive to airway stimuli.

#19) The first factor for chronic cough is the presence of a larger volume of the refluxate.

#20) The second factor for chronic cough is the oesophageal exposure to reflux for a longer period of time.

#21) Most patients with chronic cough tend not to benefit from acid inhibitory treatment.

#22) Working on acid reflux cough with natural remedies makes life a lot easier and better.

#23) There is not a single suggestion we can make to treat acid reflux cough.

#24) Avoid spicy and fatty foods, as well as a heavy meal, and integrate your diet with some highly beneficial natural products, such as ginger, or turmeric, or honey.

#25) Honey can be effective, and we can consider it like a double-treatment for cough and reflux.

#26) A holistic approach that takes care of all aspects and features of reflux is the first option in all cases.

One of the most important things to consider is the root cause that really determines cough in reflux.

The diagnosis is harder when common reflux symptoms are not present, but natural remedies will help you whatever the specific case.

What To Do Next

Now, it’s time to take action.

And not just for treating cough.

In addition to the holistic approach we suggested before, there’s more you can check.

The Proven Holistic 5-Step System


One of the best strategies. Its strength point is the holistic approach, which means that you're going to care about all aspects that may affect your organism, in 5 steps. Also known as "Heartburn No More".

The Three Everyday Ingredients


This strategy works on underestimated aspects, such as food combinations that are much more important than avoiding certain types of foods. Also known as "The Acid Reflux Strategy".

The Double Protocol For Reflux


It targets two conditions at the same time: acid reflux and infection by H. pylori. Quick warning: this book is not suitable for all reflux sufferers. Also known as "Rapid Reflux Relief".

The Reflux Remedy Kit


This is a book + kit that presents some little known and creative natural remedies for heartburn and acid reflux. A good integration. Also known as "Heartburn & Acid Reflux Remedy Report".

Take your time to decide but, before doing anything, still, remember that reflux should be treated as a whole.

A more comprehensive approach will help you win the battle against every single symptom you may experience.

Thanks for your attention and stay tuned for more!

4 Comments

  1. verthil ertva
    • Dr.Gray
  2. Vurtil
    • Dr.Gray

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