A cough can be from GERD

DEAR DR. GOTT: I had a dry, hacking cough all last winter. I went to an allergist, had a good work-up, and several ideas emerged. I was told when all else fails, try over-the-counter Prilosec, the heartburn medication. Very much to my surprise, it worked. No more cough!

DEAR READER: Gastroesophageal reflux disease (GERD) commonly causes heartburn and a sour taste in the mouth; however, nearly half of all sufferers experience a chronic cough with no other symptoms. If the heartburn medication works, you probably have GERD. You may wish to try using antacids, which are less expensive and have the additional benefit of adding extra calcium to your diet. If they do not work, go back to the Prilosec. My hat is off to your allergist for thinking outside the box of his specialty and doing everything he could to help you.

DEAR DR. GOTT: I read your response to the reader whose sister complained of a chronic, choking cough. You failed to mention idiopathic pulmonary fibrosis, which could be the cause of her symptoms. Individuals with this condition can have a chronic cough that does not respond to medications that are otherwise effective in treating chronic bronchitis or asthma. Unfortunately, there are no effective treatments, and life expectancy is between two to five years after diagnosis. More information on this condition can be found at coalitionforpf.org.

DEAR READER: When responding to readers’ questions, I may be guilty of generalizing, hitting on the most common yet overlooked possibilities. Many coughs are tied to irritants or pollutants, postnasal drip, reflux, COPD, medication reactions and a host of other reasons. Because the reader mentioned only the nagging cough, I failed to cover pulmonary fibrosis caused by an inflammatory response to an unknown substance or substances.

Idiopathic pulmonary fibrosis affects about 200,000 people, with almost 50,000 new cases reported each year. It is a condition in which the deep tissue in the lungs becomes scarred, stiff and thick. The scarring process causes the lungs to lose their ability to circulate oxygen through the bloodstream. Progression of the disease varies between individuals, with people developing either gradually, rapidly or remaining relatively stable. Heredity plays a role, as does asbestos exposure.

Symptoms include cough, dyspnea, exercise intolerance, occasional chest pain, abnormal crackling breath sounds and clubbing (fingernails that curl over the tips of the fingers).

Treatment options are somewhat limited; however, corticosteroids have been found to decrease symptoms. Diagnosis might be made through bronchoscopy, CT scan or biopsy. Patients should be under the care of a pulmonologist. Research, as with most diseases, continues. Scientists are investigating the use of several prescription medications to slow the progression of the disease.

I am sending you a copy of my Health Report, “Pulmonary Disease.†Others should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Peter Gott practiced medicine in Lakeville for 40 years.

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