Can Reflux Esophagitis Cause Coughing?

Reflux esophagitis can indeed lead to coughing. This condition occurs when stomach or duodenal contents flow back into the esophagus, causing damage to the esophageal mucosa. In addition to irritation in the esophagus, this reflux can also affect the throat and larynx, triggering a persistent, dry cough without phlegm. Many patients experience worsening symptoms at night, often waking up choking or gasping, followed by bouts of coughing.

While this phenomenon is relatively less common among Chinese populations, it remains an important extraintestinal symptom of gastroesophageal reflux disease (GERD). The most typical signs of reflux esophagitis are heartburn and acid regurgitation. As the condition progresses, individuals may develop difficulty swallowing or painful swallowing.

Besides coughing, reflux esophagitis can cause various non-esophageal symptoms. These include chronic pharyngitis with symptoms such as sore throat, hoarseness, and a sensation of a lump in the throat. Moreover, some patients may suffer from nasal congestion, runny nose, or even sinus-related discomfort due to upper airway irritation. More seriously, long-term untreated reflux has been associated with conditions like asthma, chronic cough, and pulmonary fibrosis.

To determine whether a chronic cough is caused by reflux esophagitis, healthcare providers often use a trial treatment approach. A two-week regimen combining prokinetic agents and acid-suppressing medications can help identify the underlying cause. If the cough improves significantly during this time, reflux esophagitis is likely the culprit. However, if there's no improvement, other respiratory or systemic causes should be considered and further evaluated.