The Allergist's Role in Treating Chronic Cough - Part 3

The prior two segments I discussed the nasal and chest causes of chronic cough. As an allergist, I am always searching for underlying causes with an allergic basis- because there are so many triggers in the air that affect the respiratory system. But once I rule out that a chronic cough is not due to an allergy or infection, I start digging to see if the cause of the problem isn’t in the belly.

Yes, the stomach can cause a chronic cough. Many of you are familiar with the term,” reflux”, and you see enough ads on TV for heartburn medications. However, interestingly, the patients with chronic cough that have reflux many times have no heartburn symptoms, like burning in the stomach area or chest tightness. These patients may have a form of laryngeal reflux- meaning, the acid from the stomach flows back up the esophagus and irritates the larynx (your voice box area). Sometimes, the only symptom a patient may have is constant throat clearing- it is very annoying to them and others.

To literally, put the “fire out of the belly” involves a few steps. First, dietary changes are critical. Unfortunately, if you like the heavy tomato sauces with pasta dishes- look out- this is a key culprit for reflux. If you like having those few glasses of wine each night with dinner- beware, you will be coughing the rest of the night. There are other foods that may cause the reflux as well, and you find lists of foods on-line, but you should review this with your doctor or a nutritionist. Taking acid blocker medications may give you temporary relief, but its best to try natural ways to reverse this condition, because many new studies are showing that these acid blocker medications have side-effects if used long-term: softening of the bones (osteoporosis), increased risk of infection (because the stomach acid doesn’t kill the bacteria in foods) and depletion of other partially absorbed nutrients.

My other strong belief in reversing reflux is to use breathing exercises. Why breathing exercises? I learned from an excellent osteopath that the diaphragm (the muscle in our abdomen that separates the chest from the stomach) if tense and in spasm squeezes the junction where the stomach and esophagus meet, and this is an anatomical cause of the reflux- usually from stress, but totally reversible. I discuss examples of these breathing exercises in my book, Dr. Dean Mitchell’s Allergy and Asthma Solution (Marlowe 2006) which are very helpful.

Dr. Dean Mitchell
Mitchell Medical Group, NYC & Long Island

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