Scout Moor Pharmacy » Annoying cough? Two causes you might not have considered.

Coughing is a common symptom that most people experience at some point, but when it persists, it can be a sign of an underlying condition.

The NHS guidance states that you should see a GP if your cough persists for 3 weeks or more, so we’d always encourage you to do so.

Something to consider, however, is that your cough may be linked to Gastric Oesophageal Reflux Disease (GERD) or your dairy consumption.

While GERD is a well-known as a cause of heartburn, its connection to cough may surprise some. Additionally, dairy products, though not inherently harmful for everyone, may contribute to excess mucus production and exacerbate symptoms in certain individuals. In this post, we’ll explore how both of these factors can contribute to a chronic cough and provide tips for managing symptoms.

How GERD Causes Cough

Gastroesophageal reflux disease (GERD) is a condition where stomach acid frequently flows back into the esophagus, causing irritation. While GERD is best known for causing heartburn, it can also lead to acid reflux cough, which is often persistent and irritating.

Why Does GERD Cause a Cough?

Acid Irritation: The main reason GERD leads to coughing is that stomach acid can reach the throat (pharynx) and voice box (larynx), leading to irritation and inflammation. When acid from the stomach rises into the esophagus, it can spill over into the upper respiratory tract, causing a reflexive cough to clear the throat.
Throat and Airway Sensitivity: Some individuals are more sensitive to the presence of stomach acid in the throat and may experience a “silent reflux”, where symptoms like coughing are the only noticeable signs, with little to no heartburn. This is often referred to as laryngopharyngeal reflux (LPR). The acid irritates the larynx and the vocal cords, causing swelling and discomfort, which triggers the cough reflex.
Mucus Production: In response to irritation, the body may increase mucus production to protect the lining of the throat. This excess mucus can further contribute to a chronic cough as it drips down the back of the throat (post-nasal drip).

Recognizing Reflux-Related Cough

Timing: A cough due to GERD is often worse at night or after eating, as lying down or consuming food may exacerbate reflux.
Other Symptoms: A cough due to reflux may be accompanied by a sour taste in the mouth, hoarseness, a feeling of a lump in the throat, and frequent throat clearing. Unlike a cough from a cold or flu, this type of cough doesn’t typically come with nasal congestion or a runny nose.
Persistent Cough: The cough from GERD can be chronic and may last for weeks, despite trying over-the-counter cough suppressants.

How Excessive Dairy Contributes to Catarrh and Coughing

For some individuals, dairy consumption—particularly in excess—can contribute to a sensation of increased mucus production in the throat and nasal passages, often referred to as catarrh. While there’s no strong scientific evidence that milk actually thickens mucus in healthy individuals, those with certain sensitivities, such as lactose intolerance or milk protein allergies, may feel increased mucus or congestion after consuming dairy.

How Dairy Affects the Throat

Sensory Experience of Milk: Some individuals report that consuming dairy gives them a feeling of thicker mucus in the throat. This can be more of a sensory perception rather than an actual increase in mucus production. The milk proteins, particularly casein, may contribute to a coating sensation in the throat, which some people associate with mucus.
Lactose Sensitivity: People who are lactose intolerant or have a sensitivity to certain milk proteins may also experience symptoms like congestion or a sensation of mucus in the throat. This may lead to throat clearing, coughing, and a feeling of a “lump” in the throat, but again, it’s due to digestive irritation rather than a direct effect on mucus production in the respiratory system.
Increased Mucus: For some, dairy may still appear to increase mucus production or worsen congestion, even if no true allergy exists. This could be a perception based on the way dairy affects digestion or the throat, or it could be tied to an underlying sensitivity to the components of milk.

Recognizing the Dairy-Cough Connection

Timing of Symptoms: If you notice a cough or throat clearing that worsens after consuming dairy-rich foods (like milk, cheese, or ice cream), dairy could be contributing to the problem.
Other Symptoms: If your cough is accompanied by a sensation of sticky or thick mucus in the throat, nasal congestion, or a constant need to clear your throat, dairy could be playing a role.

How to Manage Coughs Caused by GERD and Dairy

If you suspect that your chronic cough is due to either GERD or excessive dairy consumption (or both), there are several strategies you can try to alleviate symptoms:

1. Manage GERD Symptoms

Elevate the Head of Your Bed: Raising the head of your bed by about 6 to 8 inches can prevent stomach acid from flowing back into the esophagus while you sleep.
Avoid Trigger Foods: Certain foods, such as spicy dishes, citrus, chocolate, coffee, and fatty meals, can trigger reflux. Avoiding these foods, especially late at night, can help reduce symptoms.
Smaller, More Frequent Meals: Eating smaller portions more often can help prevent excessive stomach acid production.
Medications: Over-the-counter medications like antacids or H2 blockers (like ranitidine) can help reduce stomach acid. For more persistent reflux, proton pump inhibitors (PPIs) such as omeprazole can provide more effective long-term relief.
Consult a Doctor: If lifestyle changes and over-the-counter medications don’t help, a doctor may prescribe stronger medications or suggest additional treatments to manage GERD.

2. Reduce Dairy Intake

Try Dairy-Free Alternatives: Switching to dairy-free alternatives like almond milk, oat milk, or lactose-free dairy products can help reduce mucus production and ease coughing.
Limit Dairy: If you suspect dairy is contributing to your cough, try cutting back on dairy products for a couple of weeks to see if your symptoms improve.
Hydrate: Drinking plenty of water can help thin mucus, making it easier to clear from your throat and reducing the urge to cough.

3. Additional Tips for Cough Relief

Stay Hydrated: Drinking warm liquids like herbal teas with honey or warm water with lemon can soothe an irritated throat and help thin mucus.
Humidify Your Home: Using a humidifier adds moisture to the air, which can soothe the throat and reduce irritation caused by coughing.
Saltwater Gargles: Gargling with warm saltwater can help reduce throat inflammation caused by both GERD and mucus build-up from dairy.

When to See a Doctor

Here at Scout Moor Pharmacy in Edenfield, Bury, we can advise you on your cough and recommend suitable treatments. If your cough persists despite making changes to your diet or managing GERD, or if you notice worsening symptoms, we will refer you to your doctor. They may recommend further testing to rule out other causes or prescribe medications that more effectively control your symptoms. Additionally, if you have difficulty swallowing, chronic hoarseness, or if your cough is accompanied by blood or severe chest pain, seek medical advice promptly.