How do doctors determine that a cough is due to acid reflux disease (GERD), as opposed to a different cause?
Cough is a body protective mechanism in response to agents which are irritating to the airway. As such, any fumes, dust, food or fluid that accidentally enter the airway may trigger a coughing fit.
In acid reflux related cough, the most helpful clue is a feeling of stomach content flowing back into the oesophagus, otherwise known as regurgitation. Frequently, there is an associated burning sensation behind the chest bone due to the acidic stomach content. Such symptoms will make a good argument for acid reflux related cough provided there is no other better explanation for the cough such as asthma or some form of nose or airway sensitivity.
At times, a trial of acid suppression therapy for a few weeks may help to clinch the diagnosis. Special investigations such as endscopical examination of the upper airway and pH study of the upper oesophagus may be required for more complicated cases. Do consider other possibilities when treatment for reflux related cough is not working. You will probably benefit from further tests and advice from your doctor if your cough persist.
- Dr Quan
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