A cough can have various causes, from a common cold to tuberculosis. It is not always associated with the respiratory tract, pathology can occur when there is a violation of the tone of the circular muscle between the stomach and esophagus. This ailment is called gastroesophageal reflux disease (GERD). In this case, patients may confuse cough with laryngitis, bronchitis or pharyngitis, therefore, independent treatment does not have the desired effect.
The origin of cough
The reverse movement of food saturated with gastric juice is called reflux. Small doses of food pass from the stomach to the esophagus due to incomplete closure of the lower esophageal sphincter (NPS) between these organs or, more simply, the valve.
The reasons for the weakness of this valve can be very different:
- Organic factors that cause an increase in pressure in the abdominal cavity (pregnancy, flatulence, strong filling of the intestines, large neoplasms, accumulation of a large amount of fluid in the abdominal cavity).
- Squeezing the abdominal wall (wearing tight belts, tight jeans or with sharp slopes).
- Weakening of the muscle tone of the NPS due to age.
- Excessive pressure in the stomach (overeating, gas congestion, stool retention).
- Drinking alcohol, junk food, and certain medications.
- Excess weight, especially in the presence of a large abdomen.
Regular outbreaks of reflux, accompanied by heartburn, a feeling of heaviness in the stomach or behind the sternum, indicate the development of GERD.
Causes and results of persistent cough
Coughing fits with GERD remove sputum and foreign particles from the respiratory tract. The main causes of this reaction are called:
- allergic diseases;
- damage to the body by parasites;
- infections and tumors of the respiratory tract;
- violation of the gastrointestinal microflora;
- an aortic aneurysm infringing on the bronchi;
- chronic gastritis or stomach ulcer;
- external chemical effect on the bronchi;
- pathology of the rectum;
- any ailments from the liver;
- food poisoning.
Lack of diet, a sedentary lifestyle, poor quality products, bad habits can cause GERD.
Cough, caused for various reasons and lasting a long time, entails high blood pressure, impaired blood circulation in the chest and a decrease in heart rate.
Clinical picture
Gastroesophageal reflux in everyone manifests itself in different ways, it all depends on irritating factors. The combination of cough and gastroenterological pathologies helps to recognize reflux from other diseases:
- sore throats;
- ARVI;
- colds
- cough with cardiovascular failure.
Treatment with homolytic agents for gastric cough does not give the expected effect, and the urge to cough up is noticed by patients only after eating. We find out what cough with GERD happens and with which organ it is associated:
- gastrointestinal tract infections (debilitating, continuous dry cough);
- stomach ulcers, gastritis (manifests itself several hours after eating, a dull sound is heard, as if a person was choking);
- worming (cough is accompanied by respiratory dysfunction);
- enterovirus infection (difficult and painful digestion, dry cough, malaise, and abdominal cramps).
Usually at night in a horizontal position of the patient, seizures can intensify and be accompanied by vomiting.
The protective role of such attacks is that with GERD, coughing with sputum and extraneous particles that have fallen into the respiratory tract removes unnecessary coughing movements.
Pathology entails general malaise, irritability, fatigue, pain in the chest.
The manifestation of the disease
In adult patients, cough symptoms with GERD occur with some unpleasant sensations:
- Heartburn. The main difference between the disease is that it appears within 1-2 hours after eating and at night. Discomfort increases if you drink carbonated drinks and coffee. Affects a strong physical activity and overeating.
- Belching with air or gastric juice. The reason is that the contents of the stomach enter the esophagus, and then into the oral cavity. Hence the appearance of a sour taste and sore throat.
- Problem swallowing food. There is irritation of the larynx and inflammation of the walls of the esophagus, nausea and vomiting.
- Hiccups. Irritation of the phrenic nerve and contraction of the diaphragm.
- Dysphonia. The voice becomes hoarse, and when you try to speak loudly, difficulties arise.
- Respiratory manifestations. During body movements, shortness of breath and coughing appear.
In newborns, physiological gastroesophageal reflux is common, but this is due to the characteristics of the sphincter and the small capacity of the stomach. The first three months, babies regularly regurgitate, sometimes they can even vomit, but this is normal. With growing up, such manifestations disappear.
But it happens that gastroesophageal reflux disease does not go away, but progresses. Children complain of the following symptoms:
- pain while swallowing food;
- sore throat;
- feeling of a lump in the chest.
One of the alarming bells is a cough in a child with GERD, along with the detection in the morning of a pillow of whitish color, which can be called an indicator of frequent belching during sleep. The remaining symptoms of the disease in children are the same as in adults.
Appearance time
Most people with the disease do not cough with food. Often attacks begin after a meal in 30 minutes, since at this time the food is digested vigorously. Due to a defect in the lower sphincter, a cough is created between the stomach and esophagus.
Along with coughing attacks, the following manifestations are possible:
- discomfort in the upper abdomen;
- heartburn;
- dyspnea;
- sour or bitter burp.
If the patient does not eat food for more than 3 hours and feels hunger, the smell of food will lead to the production of hydrochloric acid in the stomach, which will cause severe irritation of the walls of the organ and the reflux of digestive juice into the esophagus. The result will be a coughing fit and a strong rumbling in the abdominal cavity.
Diagnostics
It is better for the patient not to self-medicate, but to consult a gastroenterologist. The specialist will diagnose:
- will take into account the complaints;
- examine the patient;
- appoint laboratory examinations.
The doctor listens to the patient's lungs and chest, examining the nature of the cough. Usually with GERD, a dry cough, exhausting the patient. It is important to pay attention to how the voice changes during the day. The following methods are most often used to diagnose gastroesophageal reflux:
- X-ray of the lungs - to exclude pneumonia or tuberculosis.
- Endoscopy of the esophagus - to detect inflammatory manifestations, erosion and ulcers.
- Daily measurement of acidity (pH) in the lower part of the esophagus. The norm of pH indicators should range from 4 to 7. Changes in actual data will indicate the development of pathology.
- Radiation diagnosis of the esophagus will help to exclude other forms of pathology.
- To assess the tone of the esophageal sphincter, a pressure test is performed.
- An esophagus biopsy is performed if Barrett's esophagus is suspected.
For proper diagnosis, it is important to distinguish - is it a cough with GERD or a consequence of another ailment.
Forms of the disease
Depending on the degree of damage to the mucous membrane of the esophagus in the disease, two forms are distinguished:
- Non-erosive. This is the most common form of pathology. It proceeds without changes in the mucosa (endoscopically negative - NERD).
- Erosive. With this form, mucosal defects of different severity are detected.
GERD complications include a precancerous condition such as Barrett's esophagus. In this case, the cells of the multilayer epithelium of the mucosa are replaced by others, for example, cells for the small or large intestine.
A healthy body is able to return the food slurry back to the stomach. At the same time, gastric juice is completely neutralized by saliva bicarbonate, which does not allow the mucosa to collapse.
What will help reduce reflux?
After identifying the causes of gastric cough, dietary recommendations of specialists are prescribed to alleviate unpleasant manifestations:
- exclude alcohol and carbonated drinks;
- normalize body weight, which will reduce the pressure inside the cavity and reduce the occurrence of reflux;
- avoid overeating, a single meal should not exceed 300-500 ml;
- food is better to cook or steam;
- eat in small portions 4-5 times a day;
- reduce the consumption of fatty foods;
- limit salty and spicy, as such food increases the production of acid and enzymes in the stomach;
- after eating, it is forbidden to take a horizontal position, reflux into the esophagus may follow, and you should not make slopes;
- night sleep should occur in the slightly raised head of the bed, approximately at the level of 15-20 cm.
Can a cough be cured with GERD? If you follow these recommendations, then the chances increase, but not always. When the pathology takes a serious form, even more stringent restrictions must be applied to nutrition. Many products are excluded, food is consumed only in grated form, the last meal should be 4 hours before bedtime.
Medical assistance
Cough with GERD occurs due to aggressive stomach contents. And treatment, in order to achieve the necessary results, should be taken seriously.
With drug therapy, the following drugs are prescribed:
- proton pump inhibitors (Omeprazole, Rabeprazole) and other antisecretory drugs;
- prokinetics to enhance intestinal and stomach peristalsis (Cerucal, Motilium);
- antacids ("Maalox", "Phosphalugel");
- vitamins to restore the mucous membrane of the esophagus.
Omnitus proved to be quite good with dry, persistent cough with GERD. The drug has a direct effect on the cough center. An excellent expectorant and anti-inflammatory agent.
Many try to get rid of the disease on their own, resorting to tinctures and decoctions. Before starting treatment, you should make sure the diagnosis is correct. Otherwise, treatment will not be beneficial. Cold cough and seizures with GERD are not so easy to distinguish.
Surgical intervention
At least they resort if the disease is not amenable to medical treatment. There are several types of surgery:
- Endoscopic methods (suturing the cardiac pulp).
- Radio frequency (damage to the layer of cardiac pulp).
- Gastrocardiopexy (therapy of hernias arising in the esophagus, with further strengthening of the ligamentous apparatus).
- Laparoscopic (during surgery, the bottom of the organ is wrapped around the esophagus).
All surgical interventions are a necessary measure and often entail side effects.
Folk Healing
Is it possible to cure cough with GERD by folk methods? Healers and healers shared some recipes to relieve unpleasant symptoms:
You will need flax seeds. A teaspoon of seeds is poured into a bowl (but not metal), pour a glass of boiling water and simmer over low heat for 5 minutes. The dishes are set aside and wrapped for half an hour. After the time is filtered through cheesecloth. Drink in the form of heat 1/3 cup 3 times a day.
- GERD cough can be treated with sea buckthorn oil or rose hip. You need to take it three times a day for a teaspoon.
- Collection of herbs. It will take 4 pinches of St. John's wort, 2 pinches of calendula, licorice, plantain, calamus, one each of tansy and peppermint. The grass is poured into an enameled bowl all mixed. The collection is poured with a glass of boiled water, covered, wrapped and insisted for 30 minutes. Having filtered, take heated 1/3 cup 3 times a day.
The consequences of not being treated
If you ignore the symptoms and cough with GERD, treatment may be longer due to complications. The most common are:
- allergic reactions;
- pathology of the respiratory system;
- aneurysms;
- Chronical bronchitis;
- pneumonia;
- pulmonary fibrosis;
- formation of tumors in the respiratory tract.
With a long period of illness or the occurrence of pathology in a chronic form, pressure in the chest increases. Circulatory malfunctions occur and heart contractions decrease. A constant spasm leads to a weakening of the elasticity of the lung tissue, which leads to emphysema.
Coughing fits with GERD can cause sleep apnea, which reduces normal lung ventilation. The patient does not receive air to the alveoli for a certain time.
Therapy of the disease should be of high quality. It is required to treat both the disease itself and the accompanying symptoms and signs.