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Lung diseases

Chronic bronchitis due to reflux

08/18/2009

Question:

Husband has had a chronic cough for over two yrs. (he explains it "like a tickle in his throat". At times a "hacking cough" at others like he has to continually clear his throat. No mucas, lungs pronounced clear, no breathing problems. Doctor diagnosed chronic broncitis due to reflux. Asked that he raise his bed 20cm and put him on "Omepral" tablets, 20mg. - 1 daily. He is 65 and recently retired. How can reflux cause this condition and what more can he do as he is not improving.

Answer:

A chronic cough can be caused by a number of things.  The most common triggers include post nasal drip due to sinus problems or allergies; medications such as ACE inhibitors; lung disease such as asthma, emphysema or chronic bronchitis; or uncontrolled acid reflux. 

Relieving the cough is sometimes difficult because several conditions may be present and require treatment at the same time. 

Many providers take a "step-wise" approach to testing or treating a condition.  If acid reflux is believed to be the culprit treatment begins with medication and lifestyle modification (raising the head of the bed at night, avoid lying down for 3 hours after a meal, reduce weight if overweight, etc).  Treatment with medications may start with H2 blockers (Zantac, Pepcid, etc..) and progress to proton-pump inhibitors (PPI) such as Nexium, Prilosec, Prevacid, Protonix, etc.  If 1 tablet of the medication is inadequate it is important to talk to your provider for an increase.  The dose or frequency are increased until the acid symptoms are controlled.  If maximum therapy is reached and the reflux symptoms are not controlled a GI specialist is generally consulted for further testing and treatment. 

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Response by:

Cathy   Benninger, RN, MS, APRN, C-AE Cathy Benninger, RN, MS, APRN, C-AE
Clinical Assistant Professor
Director, OSU Asthma Center Educational Program
College of Medicine
The Ohio State University