Chronic cough, defined as a cough that lasts for more than eight weeks, affects about one in five people. Some studies suggest there is a relationship between acid reflux and chronic cough. When patients who had a chronic cough were studied, it was clear that sometimes, acid reflux episodes increased their coughing (Kahrilas et al., 2013). While this research shows that chronic coughing may be related to reflux, there can be many different reasons (not just acid reflux) why someone would have a chronic cough.
Diagnosing a reflux-related chronic cough
Coughing is an automatic reflex of the respiratory tract that your body uses to clear your upper airways. Besides acid reflux, a chronic cough could be caused by exposure to cigarette smoke, environmental pollution, asthma, bronchitis, or allergies just, to name a few. Gastroesophageal reflux disease (GERD) is one of the most common causes of chronic cough (Irwin, 2006).
Understanding the connection between coughing and reflux can be very complicated because even when GERD causes coughing, there may be no gastrointestinal symptoms. This actually happens in the majority of cases (about 75 percent of the time). This can be very confusing to some doctors and most patients, especially if the doctor is suspecting that GERD is the cause of the chronic cough, but then the patient answers "no" when asked if he or she has experienced the more typical symptoms of acid reflux. Or, sometimes a pH monitoring test can come back negative, even though the chronic cough is related to reflux. These inconsistencies can make treating a chronic cough related to acid reflux a real challenge for the doctor and the patient.
Another complication of chronic coughing associated with acid reflux is that some people respond to treatment and others do not. Acid-suppressive treatment (PPIs) has proven to be helpful to some with a chronic cough. For others, controlling the cough with cough suppression medicine has been helpful because coughing can cause reflux, which causes more coughing, creating a vicious cycle. Anti-reflux surgery can also be an effective option.
The bottom line
Chronic coughing can have a major impact on your quality of life. Don’t let it go untreated and explore all of the possible reasons for your cough. If you suspect reflux is the cause of your chronic coughing, it is important that you connect with a health care professional who understands the complexities of this connection.