Could it be GERD with no heartburn just chronic cough?

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I have had a chronic non-productive cough off and on the past few months- but always would happen each year a few times, but definitely worse now. The cough can last 2 week to a month or longer.  My voice is hoarse alot and I feel like I am straining it to talk.  I mostly cough when I talk and especially on the phone.  I also have some mild burping, almost like a hiccup throughout the day.  Werid thing is though, I sleep all through the night and do not cough, until I wake up or get up and start moving around. Could this be GERD?  I just read that it can be GERD without heartburn.  I already had an ENT look down my throat and sinuses looked normal, but he didn't mention GERD.  Does anyone else have these symptoms and is there anything OTC? So many things OTC all say for heartburn, indigestion and don't have those things at all.  Sometimes food will get stuck in the esphogus like if chicken is too dry, or swalling some bigger vitamins.

Thank you for any info!  

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10 Replies

  • Posted

    I'm no doctor, but I get the food stuck in throat and the hoarseness, and I have Gerd. Best to get checked out, as if it is, you need to be on a PPI or a H2 blocker. 
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  • Posted

    Your symptoms are similar to mine. I'd go back to doc and ask for ent apptment.

    Gaviscon helps me but for ongoing relief throughout the day I find chewing gum not peppermint flavour but all others and especially menthol chewing gums. Don't like the aspartame etc but it really reduces the symptoms. Sometimes a chew before breakfast helps my voice.

    It's funny but I find talking on the phone more irritating than face to face. Maybe I use a hushed voice and that like whispering puts more strain on the vocal cords.

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  • Posted

    Hi Joanna, you are describing classic symptoms of extra-oesophageal reflux disease (also known as "LPR" ) .

    The deblitating cough used to be my worst symptom - especially first thing in the morning attempting tp clear the residue of mucous that has accumulated in the lungs overnight. Mine got to the point where I would cough to the point of practically passing out.

    The other symptom you mention of swallowing difficulties also resonates with me. Bread (which I always had dry as I don't like butter or spreads) and chicken breast were the two main culprits. I tell the story of when I was a head teacher awaiting the arrival of the staff for a lunchtme meeting and rushing to eat my sandwich before they arrived. It was a chicken sandwich which stuck and I lay on the floor thumping my chest trying to get it to move and hoping the staff didn't walk in and think I was having a heart attack.

    People always talk about "Acid Reflux" as if it's oe condition but acid and reflux are two separate entities. If you see a GP or a gastroenterologist, you will most likely be prescribed acid suppressant medication. This is to ensure any reflux is less damaging. But it probably won't stop the reflux and even Non-Erosive Reflux Disorder (NERD) can cause damage to the respiratory system including pneumonia and bronchiectasis.

    You need to reduce the reflux if at all possible.

    Lose weight if necessary, Stop smoking if applicable. Eat small portions but more frequently. Avoid exercise after food that will constrict the stomach. Avoid tight clothing. Leave at least 3 hours between last meal and bed. Raise th ehead of the bed by 6 to 8 inches.

    If this doesn't work, and it didn't for me, the only recourse is surgery to reduce reflux. I had a Laparoscopic Nissen Fundolication 8 years ago and it gave me my life back.

    See the www DownWithAcid org uk book / website to rad more about extra-oesophageal reflux and management thereof.

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    • Posted

      Did you cough at night? I have bouts of cough started last week. GP gave me antibiotic which helps me in the day but night is horrible. I never have that type of cough before. Can H2blocker help reduce the cough?

      Thanks

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    • Posted

      I frequently sat up for 2 hours in the night coughing (usually between 2:00 and 4:00) taking too much cough suppressant.

      Acid suppressants, be they PPIs or H2 blokers are unlikely to be effective. Athough there is a theory that acid hyper-secretion can trigger a cough reflex via the vagus nerve and a few people report they have found some modicum of relief from using them, reflux is generally a mechanical process that drugs do little to ameliorate. - They certainly didn't work for me but they do make reflux less damaging.

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    • Posted

      So do you believe everybody with lpr actually has a mechanical problem?

      I read somewhere that the fundiplication procedure is only successful in a small minority of cases but it seems it has worked 100 per cent for you.

      So you know any cases where it just goes away in time?

      I've coughed violently only twice and certainly not the magnitude you describe. Is it possible to have it without it getting any more severe.

      Also I went for a swim this morning and I was a bit worried that my throat might affect my breathing or my sore throat make hard to control my breathing but amazingly my symptoms disappeared.

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    • Posted

      I, too, am fond of swimming and was never affected by the cough because of it. But I don't swim on a full stomach.

      Whoever posted the "advice" that fundoplication is only successful in a small minority of cases didn't know what he was talking about.

      A study published in Surgical Endoscopy in 2014 reviewed the durability of Laparoscopic Fundoplication over 20 years and concluded, "Long-term results from the early experience with LF are excellent with 94 % of patients reporting only occasional or fewer reflux symptoms at 20-year follow-up. However, 18 % required surgical revision surgery to maintain their results. There is a relatively high rate of daily dysphagia but 90 % of patients are happy to have had LF." 

      The problem is, those who post on forums are more likely to be those for whom it has failed.

      These scare stories about fundoplication seem to have been spread considerably in US and related to promotion of Linx magnetic sphincter augmentation device which has been promoted by highlightng falsehoods and possible problems that may be experienced by a small minority of those having the operation whilst concealing the data about possible problems with that device.

      (Read more about reflux reduction techniques in the Down With Acid book. )

      Whether your LPR will resolve itself depends upon the origin of your reflux. For most people it is likely to be a hiatus hernia. If it is a small sliding type it is possible (but not likely) it can reposition itself.

      If your reflux is drug induced (ie the sphincter relaxes as a result of something like nicotine or alcohol) then stopping those relaxants may stop the reflux.

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    • Posted

      Thanks for your reply.

      I rad the Down with Acid book a few months the ago and I found it a refreshing g change from all quackery that pervades the Web. Since then I've read so much information about lpr that I'm not sure where I read what or who was saying it.

      I do think smoke and I very rarely have alcohol. If I do have 3 or 4 units I find I feel much better for at least the next 24 hours.

      I eat not had any tests for hiatal hernia but do you think it's necessary?

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    • Posted

      Not necessary to be tested for hiatus hernia but it helps to identify the cause of your reflux. Very many people have HH and live perfectly normally but it does mean the diaphragmatic and phrenoesophageal muscles that comprise the lower oesophageal sphincter misalign and its closure is compromised.
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  • Posted

    An unexplained chronic cough, particularly in women, is often the result of a "hypersensitive cough reflex".  Once accurately diagnosed by a Chronic Cough Specialist, treatment is rapid, easy, and effective.  We all have an involuntary cough reflex - that's what keeps foreign objects that get into our respiratory system from entering our lungs.  But some people, particularly women, are "hot-wired" to cough - that means it takes fewer triggers, and a lower level of them, to irritate the reflex and begin a coughing fit. So,you are wise not to treat the symptom (GERD) but to see a Chronic Cough Specialist to treat the problem.
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