Cough can have different causes - from a common cold to tuberculosis. It is not always associated with the respiratory tract, pathology can occur when the tone of the circular muscle between the stomach and esophagus is disturbed. This disease is called gastroesophageal reflux disease (GERD). Cough in this case, patients may be confused with laryngitis, bronchitis or pharyngitis, therefore self-treatment does not have the desired effect.
Origin of cough
The reverse movement of food saturated with gastric juice is called reflux. Small doses of food pass from the stomach into the esophagus due to incomplete closure of the lower esophageal sphincter (LES) between these organs or, more simply, the valve.
There are many reasons why this valve is weak:
- Organic factors that cause an increase in pressure in the abdominal cavity (pregnancy, flatulence, strong intestinal filling, large neoplasms, accumulation inlarge amounts of fluid in the abdomen).
- Squeezing the abdominal wall (wearing tight belts, tight jeans, or bending over sharply).
- Weakening of LES muscle tone due to age.
- Excessive pressure in the stomach (overeating, gas accumulation, stool retention).
- Using alcohol, junk food and certain medications.
- Overweight, especially if you have a big belly.
Regular reflux surges, 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 in GERD remove sputum and foreign particles from the airways. The main reasons for such a reaction are called:
- allergic diseases;
- damage to the body by parasites;
- infections and tumors of the respiratory tract;
- violation of the gastrointestinal microflora;
- Aortic aneurysm impinging on the bronchi;
- chronic gastritis or gastric ulcer;
- external chemical influence on the bronchi;
- rectal pathology;
- any liver disease;
- food poisoning.
Lack of diet, sedentary lifestyle, low quality food, bad habits can cause GERD.
Cough caused by various reasons and lasting for a long time, entails high blood pressure, impaired blood circulation in the chest and decreased heart rateabbreviations.
Clinical picture
Gastroesophageal reflux is different for everyone, it all depends on the irritating factors. The combination of cough and gastroenterological pathologies helps to distinguish reflux from other diseases:
- angina;
- ARVI;
- colds;
- cough with heart failure.
Treatment with homolytic agents for gastric cough does not give the expected effect, and the urge to cough is noticed by patients only after eating. Let's find out what kind of cough with GERD happens and with which organ it is associated:
- infection of the gastrointestinal tract (debilitating, continuous dry cough);
- stomach ulcers, gastritis (appears a few hours after eating, a dull sound is heard, as if a person has choked);
- worming (cough accompanied by respiratory dysfunction);
- enterovirus infection (difficult and painful digestion, dry cough, malaise and abdominal cramps).
Usually, at night, in the horizontal position of the patient, attacks can intensify and be accompanied by vomiting.
The protective role of such attacks is that in GERD cough with sputum and foreign particles that have entered the respiratory tract removes excess coughing movements.
Pathology entails general malaise, irritability, fatigue, chest pain.
Manifestation of illness
In adults, GERD cough symptoms occur withsome discomfort:
- 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. Strong physical exertion and overeating affects.
- Belching air or gastric juice. The reason is the ingestion of the contents of the stomach into the esophagus, and then into the oral cavity. Hence the appearance of a sour taste and sore throat.
- Problem when swallowing food. There is irritation of the larynx and inflammation of the walls of the esophagus, nausea and vomiting.
- Hiccup. Irritation of the phrenic nerve and contraction of the diaphragm.
- Dysphonia. The voice becomes hoarse and it is difficult to speak loudly.
- Respiratory manifestations. Shortness of breath and cough appear during body movements.
In newborns, physiological gastroesophageal reflux is common, but this is due to the peculiarities of the sphincter and the small capacity of the stomach. For the first three months, babies regularly spit up, sometimes they may 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 alarm bells is a cough in a child with GERD, along with detection in the morning on the pillowwhitish-colored impurities, 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.
Spawn time
Most people with the disease do not cough while eating. Often, attacks begin after a meal after 30 minutes, since food is digested vigorously at this time. A defect in the lower sphincter creates reflux between the stomach and esophagus, causing coughing.
The following manifestations are possible along with coughing fits:
- discomfort at the top of the abdomen;
- heartburn;
- shortness of breath;
- sour or bitter belching.
If the patient does not eat food for more than 3 hours and feels hungry, then the smell of food will push 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 fit of coughing and intense rumbling in the abdomen.
Diagnosis
It is better for the patient not to self-medicate, but to turn to a gastroenterologist. The specialist will diagnose:
- will take complaints into account;
- examine the patient;
- will schedule laboratory tests.
The doctor will listen to the patient's lungs and chest, studying the nature of the cough. Usually with GERD, a dry cough that exhausts the patient. It is important to pay attention to how the voice changes throughout the day. The following methods are most often used to diagnose gastroesophageal reflux:
- X-ray of lungs- to rule out pneumonia or tuberculosis.
- Esophageal endoscopy - to detect inflammation, 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 the actual data will indicate the development of the pathology.
- X-ray diagnostics of the esophagus will help to exclude other forms of pathology.
- To assess the tone of the esophageal sphincters, a manometric study is performed.
- A biopsy of the esophagus is done when Barrett's esophagus is suspected.
For a correct diagnosis, it is important to distinguish whether it is a cough with GERD or a consequence of another ailment.
Disease forms
Depending on the degree of damage to the esophageal mucosa, the disease has two forms:
- Non-erosive. This is the most common form of pathology. It proceeds without changes in the mucosa (endoscopically negative - NERB).
- Erosive. With this form, mucosal defects of varying severity are detected.
Complications of GERD include a precancerous condition such as Barrett's esophagus. In this case, the cells of the stratified epithelium of the mucosa are replaced by others, for example, cells for the small or large intestine.
A he althy body is able to return food gruel back to the stomach. At the same time, gastric juice is completely neutralized by saliva bicarbonate, which prevents the mucosa from collapsing.
What will help reduce reflux
After identifying the causes of gastric cough to relieve unpleasant manifestationsprescribed dietary advice from experts:
- eliminate 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 small meals 4-5 times a day;
- reduce fatty foods;
- limit s alty and spicy foods as they increase stomach acid and enzyme production;
- after eating, it is forbidden to take a horizontal position, reflux may follow in the esophagus, also do not bend over;
- night sleep should take place in a slightly raised head of the bed, approximately at the level of 15-20 cm.
Can GERD cough be cured? If you follow these recommendations, then the chances increase, but not always. When pathology takes a serious form, even more severe restrictions must be applied to nutrition. Many foods are excluded, food is consumed only in grated form, the last meal should be 4 hours before bedtime.
Medication assistance
Cough in GERD occurs due to the aggressive contents of the stomach. And treatment must be taken seriously to achieve the desired results.
During drug therapy, the following drugs are prescribed:
- proton pump inhibitors (Omeprazole, Rabeprazole) and other antisecretory agents;
- prokinetics to enhance intestinal and stomach motility ("Cerukal", "Motilium");
- antacids ("Maalox", "Phosphalugel");
- vitamins to restore the mucous membrane of the esophagus.
Omnitus proved to be good for dry persistent cough with GERD. The drug has a direct effect on the cough center. 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 that the diagnosis is correct. Otherwise, the treatment will not benefit. Cold cough and GERD attacks are not so easy to distinguish.
Surgical treatment
At least resorted to if the disease is not amenable to drug treatment. There are several types of surgery:
- Endoscopic methods (suturing the cardiac sphincter).
- Radiofrequency (damage to the cardiac sphincter layer).
- Gastrocardiopexy (treatment of hernias that have arisen in the esophagus, with further strengthening of the ligamentous apparatus).
- Laparoscopic (during the operation, the bottom of the organ is wrapped around the esophagus).
All surgical interventions are a forced measure and often entail side effects.
Healing folk remedies
Can a cough with GERD be cured with folk methods? Witch doctors and healers shared some recipes to relieve unpleasant symptoms:
Will be neededflax seeds. A teaspoon of seeds is poured into a bowl (only not metal), poured with a glass of boiling water and simmered over low heat for 5 minutes. The dishes are set aside and wrapped for half an hour. After the time is up, strain through cheesecloth. Drink warm 1/3 cup 3 times a day.
- Cough treatment for GERD can be done with sea buckthorn or rosehip oil. You need to take it three times a day for a teaspoon.
- Collection from herbs. You need 4 pinches of St. John's wort, 2 pinches of calendula, licorice roots, plantain, calamus, one each of tansy flowers and peppermint. The grass is poured into an enamel bowl, everything is mixed. The collection is poured with a glass of boiled water, covered, wrapped and insisted for 30 minutes. After straining, take warm 1/3 cup 3 times a day.
Consequences of lack of treatment
If GERD symptoms and cough are ignored, treatment may be longer due to complications. The most common are:
- allergic reactions;
- pathology of the respiratory system;
- aneurysms;
- chronic bronchitis;
- pneumonia;
- pulmonary fibrosis;
- Tumor formation in the respiratory tract.
With a long period of illness or pathology in a chronic form, pressure in the chest increases. There are failures in blood circulation and contractions of the heart decrease. A constant spasm leads to a weakening of the elasticity of the lung tissue, which leads to emphysema.
Coughing fits with GERD cancause sleep apnea, which reduces normal ventilation of the lungs. The patient does not receive air to the alveoli for a certain time.
Therapy of the disease must be of high quality. It is required to treat both the disease itself and the accompanying symptoms and signs.
