Nighttime Cough And Its Characteristics In Patients With Reflux Esophagitis

Reflux esophagitis can cause a range of symptoms, which are typically categorized into esophageal and extra-esophageal manifestations. One of the more common extra-esophageal symptoms is chronic coughing or phlegm production. However, this type of cough often differs from the typical cough associated with upper respiratory infections or pulmonary illnesses. It tends to occur more frequently at night, primarily due to increased acid reflux during sleep. This nocturnal cough is often described as an irritative cough, triggered when stomach acid reaches the throat and irritates the airways either directly or through reflex mechanisms.

In mild cases, patients may not experience significant phlegm production, making it more challenging to identify the link between the cough and gastroesophageal reflux. However, in some rare cases, severe reflux esophagitis can lead to pulmonary complications, such as lung infections. When this occurs, symptoms may include persistent coughing, increased mucus production, and even the presence of pus-filled phlegm. To rule out or confirm any concurrent lung infection, diagnostic imaging such as chest X-ray or CT scan is often necessary.

When lung infection is present alongside reflux-induced cough, a dual treatment approach is essential. Patients should receive both anti-reflux therapy and appropriate antimicrobial treatment under the supervision of a pulmonologist. Managing the underlying acid reflux is crucial to preventing further respiratory complications and reducing cough frequency.

Lifestyle modifications also play a key role in symptom relief. Elevating the head of the bed at night can significantly reduce acid reflux episodes and subsequent airway irritation. Additionally, the use of prokinetic medications—drugs that enhance gastrointestinal motility—can help minimize the backflow of stomach contents into the esophagus and reduce airway stimulation that leads to coughing.

By combining medical therapy with targeted lifestyle changes, individuals suffering from reflux-related cough can achieve better symptom control and improved quality of life.