Coughing and Acid Reflux: Understanding the Connection

Photo by Annie Spratt on Unsplash

I know the feeling. That annoying, nagging cough that lingers for weeks—even months—without an obvious cause. At first, you might blame allergies, a cold, or even dry air. But what if the real culprit is something completely unexpected?

For many people, chronic coughing isn’t just a respiratory issue—it’s a hidden symptom of acid reflux. If you’ve ever found yourself clearing your throat constantly, coughing after meals, or waking up in the middle of the night with a tickle in your throat, acid reflux might be playing a bigger role than you realize.

In this blog, we’ll dive into the surprising connection between acid reflux and coughing, why it happens, and—most importantly—what you can do to find relief. If you’re tired of that persistent cough and looking for answers, you’re in the right place.

What is Acid Reflux?

Acid reflux occurs when stomach acid or bile moves backward into the esophagus, the tube that connects your mouth to your stomach. Normally, a valve called the lower esophageal sphincter (LES) prevents stomach acid from flowing into the esophagus, but when this valve weakens or relaxes, acid can leak into the esophagus and cause discomfort. This leads to the common symptoms of heartburn, regurgitation, and a sour taste in the mouth.

While these symptoms are well-known, acid reflux can also cause less obvious symptoms, including a persistent cough.

How Acid Reflux Leads to Coughing

The connection between acid reflux and coughing might not be immediately obvious, but there are several ways that stomach acid can lead to respiratory symptoms:

Acid Irritation in the Throat and Lungs

When stomach acid moves into the esophagus, it can travel further up and irritate the throat, larynx (voice box), and even the airways. This condition, called laryngopharyngeal reflux (LPR) or silent reflux, occurs when acid enters the throat and causes inflammation or irritation without the typical symptoms of heartburn. The irritation can trigger a cough reflex, leading to chronic coughing, particularly at night or after eating.

Aspiration of Stomach Acid into the Lungs

In some cases, acid reflux may cause stomach contents to be inhaled into the lungs, a condition known as aspiration. This can lead to coughing as the body tries to clear the acid from the airways. Aspiration can also increase the risk of more severe respiratory conditions, like pneumonia or bronchitis.

Increased Sensitivity in the Airway

The inflammation caused by acid reflux can increase sensitivity in the airways. This makes the respiratory system more prone to reacting with a cough to even minor irritants, such as smoke, dust, or cold air. This is particularly true for people with a history of asthma, as acid reflux can exacerbate asthma symptoms and trigger coughing.

Post-Nasal Drip

Acid reflux can sometimes cause post-nasal drip, which occurs when mucus from the nose drips down the back of the throat. This can lead to coughing as the body tries to clear the mucus from the throat. The combination of post-nasal drip and acid reflux can make a persistent cough worse.

Symptoms of Acid Reflux-Induced Cough

If your cough is related to acid reflux, you may experience some of the following symptoms:

• Chronic cough (lasting more than 8 weeks)

• Hoarseness or a sore throat

• Wheezing or shortness of breath

• Sensation of a lump in the throat

• Frequent clearing of the throat

• Coughing after meals or when lying down

• Worse coughing at night or in the morning

If you suspect that your cough is related to acid reflux, it's important to consult with a healthcare provider for an accurate diagnosis.

How to Manage Coughing Due to Acid Reflux

If your chronic cough is caused by acid reflux, there are several strategies you can use to manage both the cough and the underlying reflux symptoms:

Elevate Your Head While Sleeping

Sleeping with your head elevated can help prevent acid from flowing back into the esophagus while you sleep. Use pillows or a wedge to elevate your head by about 6–8 inches. This can help reduce nighttime coughing associated with acid reflux.

Avoid Eating Before Bed

Give your digestive system time to process food before lying down. Try to avoid eating at least 2–3 hours before bedtime. This reduces the likelihood of reflux when you lie down to sleep.

Eat Smaller Meals

Eating large meals can increase pressure on your stomach, making it easier for acid to leak into the esophagus. Instead, opt for smaller, more frequent meals throughout the day.

Limit Acidic and Trigger Foods

Certain foods can trigger or worsen acid reflux, including spicy foods, citrus, chocolate, caffeine, and fried or fatty foods. Keeping a food diary to track what triggers your reflux symptoms can help you avoid these foods and prevent coughing.

Use Medications as Directed

Over-the-counter medications such as antacids, H2 blockers, or proton pump inhibitors (PPIs) can help reduce stomach acid and manage reflux symptoms. However, these should only be used under the guidance of a healthcare provider.

Quit Smoking

Smoking can weaken the lower esophageal sphincter (LES), making reflux symptoms worse. If you smoke, quitting can significantly improve both your acid reflux and coughing symptoms.

Stay Hydrated

Drinking plenty of water throughout the day can help dilute stomach acid and keep your throat moist, reducing irritation and coughing.

Consult a Doctor

If your cough persists despite these lifestyle changes, or if you’re concerned that acid reflux may be causing damage to your respiratory system, consult with a healthcare provider. They may recommend tests such as a pH monitor, endoscopy, or lung function tests to assess the severity of your acid reflux and cough.

Conclusion

A persistent cough is not always just a sign of a cold or allergies—it could be a symptom of acid reflux. If you’re dealing with chronic coughing and other reflux symptoms, there may be a connection that needs to be addressed. By understanding how acid reflux can affect your throat and lungs, you can take proactive steps to manage both your cough and your digestive health.

With the right treatment plan and lifestyle changes, you can reduce acid reflux symptoms and get relief from that chronic cough. If you're unsure about the cause of your cough, it's important to seek professional advice for a proper diagnosis and treatment options.