Reflux & cough

[TikkiRo]

Has anyone else come across or heard of anyone having not just a cough with GERD, but a perpetual, life-destroying one with that condition??   I've had the diagnosis of GERD for 4 years+ now, and accept that my chronic dry cough is coming from my stomach/reflux, but struggle to understand why it's so horrendous.  I start around 7 am where it will wake me up and if I don't get it controlled (with gripe water) I invariably start retching and usually bring up mostly gas and lots of it.   On days where I'm not taking my pain meds (OxyContin) until later in the day for any reason, I end up continually coughing regardless of any attempt to quell it.  I'm on 80 mg of Nexium already and have known erosions, but am just exhausted coping with this problem.   I also figure I'm on the verge of getting a prolapse or hernia with the intensity of it at times (I'm quite thin) and no doc I've spoken to seems to have come across it being quite such an intense symptom as I have experienced and if anything it appears to be escalating in frequency.  I've been checked out for other respiratory causes and none have been found, so the docs are pretty sure it's "stomach related" - but I'm just wondering if anyone else has found this to any degree.   I suffer from Sjogren's syndrome as well as lupus both conditions I know can cause GI problems through biochemical changes and I have often felt the SJS has perhaps provoked an oversensitive cough reflex but hard to know whether this is related.  Any thoughts??

[TikkiRo]

I'm actually already on Lyrica and have been (albeit on a low dose of 75 mg) for 2 years now partly for sleep and partly for neuropathic arm pain - really not keen to up the dose as I've suffered more in not being able to function appropriately during the day when I do, but never thought of a possibility of a "neuropathic cough".   But the Lyrica sort of precludes the concept of my arising any earlier - even trying to get myself up by 8 for early morning appts is truly tough - like trying to swim through sludge, so not keen on the idea of trying to be up before the cough kicks in at 6.  But I've now undertaken a little bit of research on my own about this and am changing my dietary intake first off to see what that does.  

I never understood why everyone banged on about caffeine but now I appreciate the biochemistry a bit better, I can see that my years of caffeine intake may not have helped - while my GI doc felt that my system has adapted to it and thus he feels that's not my problem, I would have to disagree.  SO, I'm cutting way back on what caffeine I do have in a day and see if that might help - ironically though, since starting this last week, and switching to diluted juices I've already had a rapid increase in the cough and definite heartburn which I normally don't notice, which is frustrating.  It would seem my stomach really doesn't like fruit in any shape or form but I can't abide plain or flavoured waters so little else to try.  

I'm truly not keen taking such high doses of nexium as they can't be good longterm, so really want to try and help my stomach revert to "normal" chemistry where possible.  The problem will always be not knowing how much is diet and how much down to SJS, but at least if I tackle one perhaps the other will settle too.  Thanks for your input.

[wishing24]

Have you ever seen a neurologist concerning this bad cough. It is possible that besides the reflux from the GERD that you could have some neuropathy causing the cough. With Sjogrens anything is possible. It is the disease that keeps on giving. It might be worth trying something like gabapentin or Lyrica for neuropathy before you do a big surgery.

Just out of curiosity, do you cough like this if you set your alarm clock and get up earlier before the coughing starts. The bodies systems are pretty quiet until towards morning when everything starts to rev up. Is  it possible that you are starting to produce more acid at this early hour and this kicks the cough into motion. Wishing 24

[TikkiRo]

Thanks for all your responses - I've now seen my GI doc once again, and he's going to investigate things a little further in this direction at least i.e. just had a barium meal done (had a scope last year which showed erosions, so not repeated), and depending on the results I think he's going to set me up for the pH and motility tests.  He has mentioned the Nissen to me but to be honest I don't cope well with surgeries as my pain levels seem to escalate so fast and take so long to get under control again, so I tend to not opt for them unless unavoidable.   But we'll see what his view is at the end of the tests as he may change his mind.

1ph - thanks for your indepth info on SJS - you mention a lot of very interesting points - I'm a caffeine addict (Coke, chocolate and coffee with the 1st 2 being the worst) plus tend to eat a high carb diet too, but have literally just this week determined to try and do something diet wise to improve my life in general.  I'm very underweight tho, so trying to be careful how I switch things around as given 2/3 of my calorie intake is probably in sugar (partly because I've little appetite for decent food apart from my dinner which I do eat), I'll have to try and add in other high calorie foods to keep things stable.   Also interesting is that I have a mint chocolate addiction and have had for many years now, yet can't tolerate ordinary "sucky" mints in any shape or form.   I've been on one elimination diet previously when being investigated for coeliac disease, and lost a lot of weight very rapidly from just cutting out bread and cakes (neither of which I eat to any huge degree!), and find very few alternatives I like enough to bother actually eating.  

My GI doc said that most likely the Coke has changed my stomach chemistry to accommodate it over so many years (40!!) and so it will take time to retrain it back to normality and age is now somewhat against me (not to mention all the other conditions), but while he felt the Coke wasn't the problem nor the solution, I just feel it's time to try harder to kick the habit (having failed on all prior occasions as I hate water and can't tolerate most other fluid alternatives because of the reflux), and work to improve this situation myself.   So thanks again for those tips and info.  I'm in the UK but we have plenty of similar supplements to try and I'll go see if I can find them.  Romayne

[1ph]

The sjogren's  means that some digestive enzymes are absent. That makes a problem with digestion of foods , usually carbohydrates.  Since it is an autoimmune disorder, it seems to effect everything.
Probiotics have been found to help with GERD for some people.
And can markedly help the gas.The only one that is FDA approved is FLuoro Q . As far as i know it is also the only one that is gluten free. But there are many others on the market.
With your symptoms bother you so much, you might want to cosider the more potent on , which is Fluoro q 2 for a few months until you get under some better control.

Since many people with Sjogren's have many food sensitivities it is hard work to figure out which ones are aggravating the GERD.  For some this means a food diary and sometimes what is called an elimination diet.
Some of the worst food culprits that are often overlooked.  are coffee, caffein and mint.
The Oxycontin can also cause stomach upset.
Proper treatment for Sjogren's and Lupus can reduce the degree of inflammation in the body and make the GERD better, not cured.
www.sjogrens.netfirms.com  has more information.

[maddo]

ask the doctor if a fundoplication will help, cause if you can control the gerd it will be awesome outcome. im going for the operation tomorrow and the specialist tells me that after i have this procedure done i will have my life back

[jmbirds]

my mom acts like sojourns but the test was negetive now excessive use of acid reducers are known to cause stomach issues polyps benign  and malignant depending on the duration have you had a gastro scope lately? get some biopsys done  did you try going to a chiropractor alot of our vertebrae can irritate us to cough, also blood pressure medication can bring on a faux sojourns thats what my mom has the pseudo symptoms your bladder control blood pressure medication can bring on dry mouth ,