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choking cough: reflux symptom?
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| This is the second time I've had this: A horrible choking cough, bad
enough that sometimes I vomit. In fact, the cough is almost exactly
like when one is going to vomit, except that there's no nausea or upset
stomach. Just this horrific cough that often ends in a choking sound.
It's like I'm trying to dislodge something way up high in my throat,
it's often preceded by a sudden, intense cough tickle in the back of my
throat. In between attacks, my throat feels completely fine, no stomach
upset or other GERD symptoms that I can tell.
When I had this before I was on antibiotics for months with an
assumption of bronchitis (no diagnosis, this is the UK we're talking
about here). It never really went away, but just turned down into a
regular, nonproductive cough.
I'm on 30mg/day lansoprazole, but again, there was no definitive
diagnosis, just based on symptoms (a chest pain that wasn't my heart).
Had a barium swallow that found nothing. Assumption: "floppy les".
Before the chest pains I had a cough which I now think was a reflux
symptom, just a nagging dry cough with no known reason.
Could this cough be a worsening of my acid reflux symptoms? Is there
any way I can safely test this myself (higher dose of my med, or add
another different type?), since I have absolutely no confidence in my
NHS gp?
Oh, after it was bad and got better, it's been in this holding pattern
where I'd barely cough during the day, but right at a certain point as
I'm falling asleep, something would relax in my throat and I'd start to
cough. I'm nearly afraid to go to sleep now. I don't cough while
asleep, but almost always have a coughing fit just as I wake up. Again,
does this sound like a GERD symptom?
I've tried some other ideas - took an allergy med, still coughing.
Cough medicine isn't doing much. Sinus meds, nada. I do have an appt
with a thoracic doc in a couple of weeks, if I don't go insane before then.
Incidentally, I've tried raising the head of the bed as is often
recommended, but I just can't sleep that way.
Any help appreciated.
jmc
| |
| Howard McCollister 2006-03-22, 1:31 pm |
|
"jmc" <NOnewsgroupsSPAM@NOjodiBODY.HOMEus> wrote in message
news:473jf1Fdh9jtU1@individual.net...
> This is the second time I've had this: A horrible choking cough, bad
> enough that sometimes I vomit. In fact, the cough is almost exactly like
> when one is going to vomit, except that there's no nausea or upset
> stomach. Just this horrific cough that often ends in a choking sound.
> It's like I'm trying to dislodge something way up high in my throat, it's
> often preceded by a sudden, intense cough tickle in the back of my throat.
> In between attacks, my throat feels completely fine, no stomach upset or
> other GERD symptoms that I can tell.
>
> When I had this before I was on antibiotics for months with an assumption
> of bronchitis (no diagnosis, this is the UK we're talking about here). It
> never really went away, but just turned down into a regular, nonproductive
> cough.
>
> I'm on 30mg/day lansoprazole, but again, there was no definitive
> diagnosis, just based on symptoms (a chest pain that wasn't my heart). Had
> a barium swallow that found nothing. Assumption: "floppy les".
>
> Before the chest pains I had a cough which I now think was a reflux
> symptom, just a nagging dry cough with no known reason.
>
> Could this cough be a worsening of my acid reflux symptoms? Is there any
> way I can safely test this myself (higher dose of my med, or add another
> different type?), since I have absolutely no confidence in my NHS gp?
>
> Oh, after it was bad and got better, it's been in this holding pattern
> where I'd barely cough during the day, but right at a certain point as I'm
> falling asleep, something would relax in my throat and I'd start to cough.
> I'm nearly afraid to go to sleep now. I don't cough while asleep, but
> almost always have a coughing fit just as I wake up. Again, does this
> sound like a GERD symptom?
>
What you are describing is pretty classic for LPR (laryngeopharngeal
reflux), a distinct subset of GERD.
Look at
http://www.google.com/search?hl=en&...lux&btnG=Search
HMc
| |
|
| jmc...I have been through so much crap with doctors in my life in several
specialties (ENT, pulmonology, gastro, back surgeons, and the dreaded uro -
not to mention my unknown immune deficiency that will probably be the cancer
straw that broke the camel's back), that I can not help but comment on this.
I mentioned in previous threads that I have been to the tertiary care
centers in Baltimore, MD three times in my life (you know - go there because
they are supposed to know more - that's bullshit - doctors are the same all
over - a gastro is a gastro and a uro is a uro). Where the big cities are
better, is they have the capabilities to do advanced state of the art
surgeries - and of course the big hospital centers do get involved in
research grants that they get.
Anyway I have nothing to show for it (once to John Hopkins for my
sarcoidosis, and once to Univ of Maryland for chronic coughing/mucous
problems (since 1996 got worse after third nose operation), and once to Univ
of Maryland for gastro second opinion which I got nothing from at all except
the worst bronchitis of my life (after the 24 hour ph and manometry), which
I have mentioned to Howard and you all in another thread.
You may very well have LPR (that Howard mentioned), but I just want to let
you know that almost every ENT you go to (I have been to oodles of them)
will sound like a tape recorder and blame it on LPR. And to top that off, I
went to a real bad gastro once because an ENT recommended I see a gastro for
my coughing, and the damn gastro started cursing me out and said he was
"sick of the goddamn ENT's sending their patients to him" and he was going
to write them a letter - I felt like saying they're right across the hall,
why don't you just go tell them in person - the chicken shit loud mouthed
XXXXXXX - this is another doctor who should not be practicing medicine IMO.
At Univ of MD, I first went to an ENT for my coughing/mucous problems in
1996 (I was referred to by my old pulmonologist at the time who is one of
the few good doctors I have been to in my life). The ENT said I should
increase my prevacid from 15 mg to 30 (I had already been on 15 and it
handled my heartburn completely - and before Howard says that doesn't mean
you still can't have LPR, I know that). Any way the 30 mg didn't help (and
I knew it wouldn't), so the ENT sent me to one of his fellow teaching
doctors (another ENT) who specialized in larynx's and vocal cords
(whoopee!). That was another joke. That doc told me I needed to be on a
bi-daily med and to take prilosec 20mg twice a day, and also prescribed the
dreaded propulsid which was outlawed by the FDA shortly thereafter due to
heart interaction problems, which I can attest to. I told the doc I had
already been on prilosec (20mg bidaily) previously in my life and I doubted
it would stop my coughing or mucous problems, but I tried it anyway and it
did not help, and I did not go back.
Incidentally, to this day I believe my coughing and mucous problems got
worse as a result of my third nose operation (laser assisted turbinectomy).
You can go to the pulmonologist, but you may end up on one of the dreaded
winding roads of one discipline trying to blame it on another discipline
(been through that many times, in the perineal areas of the body
especially). If I sound negative excuse me, but I know Vanny knows what I
am talking about, and I believe you do to (per your post on the bad medical
system in England in one of Preesi's threads). I'm sure the pulmo will want
a chest CT if the flat view Xray is non specific (and he will certainly want
one if the flat view shows anything suspicious at all).
For what its worth I tried every steroid inhaler and nasal spray available
in the mid 1990's with no real help. I also have sarcoidosis which was
diagnosed by thoracoscopy in 1992.
jmc...do you have a name like Jane or Joan or something. I hate it when I
have to refer to people by initials or abbreviations or acronyms or what
ever. I'm sure you know my name is Pete :-):-) .
Please keep us informed on your condition, and what the pulmonologist said.
You mentioned your gen practitioner. Have you been to an ENT for your
coughing. They can do a simple laryngoscopy in the office while you are
there, which may at least rule out some things...Pete
jmc wrote:
> This is the second time I've had this: A horrible choking cough, bad
> enough that sometimes I vomit. In fact, the cough is almost exactly
> like when one is going to vomit, except that there's no nausea or
> upset stomach. Just this horrific cough that often ends in a choking
> sound. It's like I'm trying to dislodge something way up high in my
> throat, it's often preceded by a sudden, intense cough tickle in the back
> of
> my throat. In between attacks, my throat feels completely fine, no
> stomach upset or other GERD symptoms that I can tell.
>
> When I had this before I was on antibiotics for months with an
> assumption of bronchitis (no diagnosis, this is the UK we're talking
> about here). It never really went away, but just turned down into a
> regular, nonproductive cough.
>
> I'm on 30mg/day lansoprazole, but again, there was no definitive
> diagnosis, just based on symptoms (a chest pain that wasn't my heart).
> Had a barium swallow that found nothing. Assumption: "floppy les".
>
> Before the chest pains I had a cough which I now think was a reflux
> symptom, just a nagging dry cough with no known reason.
>
> Could this cough be a worsening of my acid reflux symptoms? Is there
> any way I can safely test this myself (higher dose of my med, or add
> another different type?), since I have absolutely no confidence in my
> NHS gp?
>
> Oh, after it was bad and got better, it's been in this holding pattern
> where I'd barely cough during the day, but right at a certain point as
> I'm falling asleep, something would relax in my throat and I'd start
> to cough. I'm nearly afraid to go to sleep now. I don't cough while
> asleep, but almost always have a coughing fit just as I wake up. Again,
> does this sound like a GERD symptom?
>
> I've tried some other ideas - took an allergy med, still coughing.
> Cough medicine isn't doing much. Sinus meds, nada. I do have an appt
> with a thoracic doc in a couple of weeks, if I don't go insane before
> then.
> Incidentally, I've tried raising the head of the bed as is often
> recommended, but I just can't sleep that way.
>
> Any help appreciated.
>
> jmc
| |
|
| Suddenly, without warning, Howard McCollister exclaimed (07-Mar-06 1:05 AM):
> "jmc" <NOnewsgroupsSPAM@NOjodiBODY.HOMEus> wrote in message
> news:473jf1Fdh9jtU1@individual.net...
>
> What you are describing is pretty classic for LPR (laryngeopharngeal
> reflux), a distinct subset of GERD.
>
> Look at
>
> http://www.google.com/search?hl=en&...lux&btnG=Search
>
> HMc
>
>
>
Howard:
Thank you. I'll keep that in mind. For now though, my research
suggested sinusitis as well, and I found a nasal irrigation bottle in my
medicine cupboard (actually, it's something with grapefruit seed
extract). At any rate I used it and... it's a miracle! Didn't cough,
sinuses have cleared up (tho there's a bit of pressure), I feel much better.
But I have a question for you. I came across references that GERD can
cause sinusitis. Can you explain how?
jmc
| |
|
| Yes, typical symptom and loved by docs. because it is generally the only one
that they remember apart from heartburn. As well as that I have sorethroat
and stomach ache. Life-style changes are required in addition to the mediine
prescribed by your doc. for the management of GERD
http://www.gicare.com/pated/ecdgs39.htm .
GERD: http://www.reutershealth.com/wellconnected/doc85.html
V.
"jmc" <NOnewsgroupsSPAM@NOjodiBODY.HOMEus> schrieb im Newsbeitrag
news:473jf1Fdh9jtU1@individual.net...
This is the second time I've had this: A horrible choking cough, bad
enough that sometimes I vomit. In fact, the cough is almost exactly
like when one is going to vomit, except that there's no nausea or upset
stomach. Just this horrific cough that often ends in a choking sound.
It's like I'm trying to dislodge something way up high in my throat,
it's often preceded by a sudden, intense cough tickle in the back of my
throat. In between attacks, my throat feels completely fine, no stomach
upset or other GERD symptoms that I can tell.
When I had this before I was on antibiotics for months with an
assumption of bronchitis (no diagnosis, this is the UK we're talking
about here). It never really went away, but just turned down into a
regular, nonproductive cough.
I'm on 30mg/day lansoprazole, but again, there was no definitive
diagnosis, just based on symptoms (a chest pain that wasn't my heart).
Had a barium swallow that found nothing. Assumption: "floppy les".
Before the chest pains I had a cough which I now think was a reflux
symptom, just a nagging dry cough with no known reason.
Could this cough be a worsening of my acid reflux symptoms? Is there
any way I can safely test this myself (higher dose of my med, or add
another different type?), since I have absolutely no confidence in my
NHS gp?
Oh, after it was bad and got better, it's been in this holding pattern
where I'd barely cough during the day, but right at a certain point as
I'm falling asleep, something would relax in my throat and I'd start to
cough. I'm nearly afraid to go to sleep now. I don't cough while
asleep, but almost always have a coughing fit just as I wake up. Again,
does this sound like a GERD symptom?
I've tried some other ideas - took an allergy med, still coughing.
Cough medicine isn't doing much. Sinus meds, nada. I do have an appt
with a thoracic doc in a couple of weeks, if I don't go insane before then.
Incidentally, I've tried raising the head of the bed as is often
recommended, but I just can't sleep that way.
Any help appreciated.
jmc
| |
|
| Suddenly, without warning, Howard McCollister exclaimed (07-Mar-06 1:05 AM):
> "jmc" <NOnewsgroupsSPAM@NOjodiBODY.HOMEus> wrote in message
> news:473jf1Fdh9jtU1@individual.net...
>
> What you are describing is pretty classic for LPR (laryngeopharngeal
> reflux), a distinct subset of GERD.
>
> Look at
>
> http://www.google.com/search?hl=en&...lux&btnG=Search
>
> HMc
>
>
>
Howard:
Thanks. I have a weird question. I've not enough data yet to say this
is actually happening in truth, but what if I was to tell you that if
the cough starts when I'm sitting down, it'll stop or at least reduce in
severity if I get up and walk away? Would I be hallucinating?
I do still have the cough, can't tell at this point if it's my sinuses
or GERD. I'll know more after dinner. If I get it again after we've
eaten, then I'll put my $$ on GERD, though it's happening throughout the
day - the first fit after I've eaten a meal seems to be the worse.
jmc
| |
| Howard McCollister 2006-03-22, 1:31 pm |
|
"jmc" <NOnewsgroupsSPAM@NOjodiBODY.HOMEus> wrote in message
news:475vujFe2j1uU1@individual.net...
>
> Thanks. I have a weird question. I've not enough data yet to say this is
> actually happening in truth, but what if I was to tell you that if the
> cough starts when I'm sitting down, it'll stop or at least reduce in
> severity if I get up and walk away? Would I be hallucinating?
No, not necessarily. Sitting will increase intraabdominal pressure which
will augment the pressure gradient across the LES, which in turn promotes
reflux.
HMc
| |
|
| Suddenly, without warning, Howard McCollister exclaimed (07-Mar-06 1:05 AM):
> "jmc" <NOnewsgroupsSPAM@NOjodiBODY.HOMEus> wrote in message
> news:473jf1Fdh9jtU1@individual.net...
>
> What you are describing is pretty classic for LPR (laryngeopharngeal
> reflux), a distinct subset of GERD.
>
> Look at
>
> http://www.google.com/search?hl=en&...lux&btnG=Search
>
> HMc
>
>
>
Howard:
Finally noticed you'd given me a google link to explore  I've had a
look, sure does sound like my reflux has become, or most likely always
has been, LPR. I've had that 'lump in the throat' problem for many
years. I'll make an appt with my GP to have a look and see if my
throat's inflamed. I know it was when I last saw a gastro, but he
diagnosed a 'floppy les' and I don't remember him mentioning LPR.
Maybe it'll diminish after this period of stress. We're getting ready
to move from one overseas location to another, and due to other issues
this is a more stressful move than similar ones we've done before.
What do you think is relaxing that causes my just-as-I-fall-asleep
cough? My vocal chords? The upper sphincter?
Thanks for your help.
jmc
| |
| Howard McCollister 2006-03-22, 1:31 pm |
|
"jmc" <NOnewsgroupsSPAM@NOjodiBODY.HOMEus> wrote in message
news:478i2dFediq1U1@individual.net...
>
> What do you think is relaxing that causes my just-as-I-fall-asleep cough?
> My vocal chords? The upper sphincter?
>
Reflux of gastric contents across the LES, up the esophagus and hitting the
vocal cords. After the LES, there's really nothing to stop such reflux.
Irritation of the vocal cords is an intense coughing stimulus.
HMc
| |
|
| Suddenly, without warning, Howard McCollister exclaimed (08-Mar-06 6:20 PM):
> "jmc" <NOnewsgroupsSPAM@NOjodiBODY.HOMEus> wrote in message
> news:478i2dFediq1U1@individual.net...
>
> Reflux of gastric contents across the LES, up the esophagus and hitting the
> vocal cords. After the LES, there's really nothing to stop such reflux.
> Irritation of the vocal cords is an intense coughing stimulus.
>
> HMc
>
>
>
Howard:
Is there anything I can try until I can get to my GP (it's evening
here)? I'm coughing at least once an hour now (was OK this am but
getting worse throughout the day). I'm afraid tonight might be like
last night - neither me nor my husband (and probably my cat too) got
much sleep, due to my coughing. And when I wasn't coughing, I was
afraid to fall asleep, because I knew what would happen... Cough
medicine sometimes provides temporary relief, but not nearly for the 4
hours - I suspect it's just providing relief by coating the irritated
areas. I have some rantinidine (sp?) and some OTC zantac, as well as Malox.
jmc
| |
| Howard McCollister 2006-03-22, 1:31 pm |
|
"jmc" <NOnewsgroupsSPAM@NOjodiBODY.HOMEus> wrote in message
news:478pd6Feias9U1@individual.net...
> Howard:
>
> Is there anything I can try until I can get to my GP (it's evening here)?
> I'm coughing at least once an hour now (was OK this am but getting worse
> throughout the day). I'm afraid tonight might be like last night -
> neither me nor my husband (and probably my cat too) got much sleep, due to
> my coughing. And when I wasn't coughing, I was afraid to fall asleep,
> because I knew what would happen... Cough medicine sometimes provides
> temporary relief, but not nearly for the 4 hours - I suspect it's just
> providing relief by coating the irritated areas. I have some rantinidine
> (sp?) and some OTC zantac, as well as Malox.
>
Try it all. Nothing to eat at all after about 7 PM. Sleep reclining. Small
meals only - DO NOT overfill your stomach. No bending or stooping. No spicey
foods, especially tomato-based spices or sauces. Bias your diet more toward
mild carbohydrates rather than emphasizing protein or fat. No alcohol, no
nicotine, no caffiene. No carbonated beverages. Cough suppressants are fine,
but not likely to help. Anti-secretory medication such as H2 blockers or
PPIs is definitely a good idea. An antacid likewise is a good idea - it
won't stop the reflux but does have the benefit of neutralizing the acidity
of the material you DO reflux, which in turn decreases vocal cord irritation
and less chance of bronchitis due to micro-aspiration. Don't forget the
ginger root juice
Unfortunately, it may well take a few days for everything to settle down,
but hang in there.
HMc
| |
|
| Suddenly, without warning, Howard McCollister exclaimed (08-Mar-06 8:22 PM):
> "jmc" <NOnewsgroupsSPAM@NOjodiBODY.HOMEus> wrote in message
> news:478pd6Feias9U1@individual.net...
>
>
>
> Try it all. Nothing to eat at all after about 7 PM. Sleep reclining. Small
> meals only - DO NOT overfill your stomach. No bending or stooping. No spicey
> foods, especially tomato-based spices or sauces. Bias your diet more toward
> mild carbohydrates rather than emphasizing protein or fat. No alcohol, no
> nicotine, no caffiene. No carbonated beverages. Cough suppressants are fine,
> but not likely to help. Anti-secretory medication such as H2 blockers or
> PPIs is definitely a good idea. An antacid likewise is a good idea - it
> won't stop the reflux but does have the benefit of neutralizing the acidity
> of the material you DO reflux, which in turn decreases vocal cord irritation
> and less chance of bronchitis due to micro-aspiration. Don't forget the
> ginger root juice
>
> Unfortunately, it may well take a few days for everything to settle down,
> but hang in there.
>
> HMc
>
>
>
Thanks. Haven't eaten anything since 6pm. I already hardly drink,
don't smoke, and had to give up caffine due to my heart. Don't drink
sodas either, as my system really doesn't like aspartame and I don't
like sugary drinks. Don't have any ginger root juice on hand, but do
have some candied ginger... and I've tried sleeping elevated. I have
trouble enough sleeping, just can't do it elevated at all.
I took my lansoprazole this morning; if I get desperate I'll try the
rantinine (or however the darn thing's spelled) - I read somewhere
that's OK. I keep sipping water each time I start to cough, but of
course that means more of a broken sleep
Thanks for the advice. Hopefully all will be well once I remember to
keep taking my meds.
jmc
| |
|
| jmc wrote:
> Suddenly, without warning, Howard McCollister exclaimed (08-Mar-06
> 8:22 PM):
> Thanks. Haven't eaten anything since 6pm. I already hardly drink,
> don't smoke, and had to give up caffine due to my heart. Don't drink
> sodas either, as my system really doesn't like aspartame and I don't
> like sugary drinks. Don't have any ginger root juice on hand,
jmc...I believe Howard was being facetious about the ginger root juice.
Obviously you haven't been following all the discussions in the other
threads. And you still haven't told my what your name is. If you don't
want to, fine...Pete
but do
> have some candied ginger... and I've tried sleeping elevated. I have
> trouble enough sleeping, just can't do it elevated at all.
>
> I took my lansoprazole this morning; if I get desperate I'll try the
> rantinine (or however the darn thing's spelled) - I read somewhere
> that's OK. I keep sipping water each time I start to cough, but of
> course that means more of a broken sleep
>
> Thanks for the advice. Hopefully all will be well once I remember to
> keep taking my meds.
>
> jmc
| |
|
| Suddenly, without warning, Pete exclaimed (09-Mar-06 2:07 AM):
> jmc wrote:
>
> jmc...I believe Howard was being facetious about the ginger root juice.
> Obviously you haven't been following all the discussions in the other
> threads. And you still haven't told my what your name is. If you don't
> want to, fine...Pete
>
>
Pete: Well, I was following it but I guess my sense of humor was
broken. I was pretty unhappy last night, but better today. As for my
name, it's Jodi.
jmc
|
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