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Elizabeth asked...

Persistent cough caused by reflux

I have a persistent cough as I suffer from reflux. I am on Nexium 20mg twice daily. Can you advise me about this irritating " bark"?

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The answer

There can be a number of reasons as to why you have a persistent cough. A number of factors can give a clue as to what the likely cause is. These include:

  • How long have you had the cough? If it is longer than two weeks then your doctor will need to examine you.
  • Are there any other symptoms associated with it? Are you short of breath or wheezy? Does your chest hurt when you cough? Have you had fever or weight loss?
  • Is it dry or chesty? 

A chesty cough is when you can bring up phlegm, however little, from the chest on coughing. If you can bring up the phlegm what colour is it? If it is yellow, green or blood stained then this needs further investigation and you may need an antibiotic.

A dry cough is when you are not producing such phlegm. Coughs associated with acid reflux tend to be dry. It could be an allergic reaction.

  • Do you wake up coughing in the middle of the night or is the cough worse at night? If this is the case then it could be associated with a respiratory illness such as asthma. If you have been prescribed an inhaler by your doctor are you using it correctly?
  • Do you smoke? If you do then it is still worth having the investigations. Of course it would be prudent to stop smoking. These days there are various aids to help you stop smoking. If you need further information on these aid please do not hesitate to contact us.

The usual dose of Nexium can be 40mg once a day. People who suffer with Zollinger Ellison Syndrome can be prescribed higher doses. Doses over 80mg daily can be given twice a day. A 20mg twice a day is unusual but this needs to be discussed with your doctor.

As you can see there are many different criteria to consider  and possible investigations to be carried out before deciding on the most appropriate  treatment for the barking cough. This is why I suggest that you discuss this matter with your doctor.

Meanwhile a spoonful of honey can help. Honey acts as an antiseptic  and the sugary content can help with soothing and healing raw surfaces at the back of the throat so making the area slippery. This will stop the ‘itch cough’ cycle.  However, honey will help with controlling  the symptoms only and not the actual cause.

Answered by the Health at Hand nurses  

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