Reports link coughing to reflux

Dear Dr. Gott: For the past six months or more, I’ve begun coughing immediately following a meal. My doctor checked me for congestion, ordered a chest X-ray and CT scan, but found nothing. Do you have any suggestions?

Dear Reader: Yes, I do.

In the past few months, more and more medical reports have emphasized the relation between coughing and reflux (which is often caused by hiatal hernia).

Reflux is a strikingly common condition, marked by backwash of stomach acid into the esophagus, leading usually to heartburn and bloating. However, cough may be the only symptom, and it tends to occur after meals (when the stomach contracts) or when a person lies down.

You can test this hypothesis by taking a dose of liquid antacid (Maalox, Gelusil or others) at the conclusion of your meals. If this simple remedy prevents your cough, the problem is solved.

If not, you should have an upper GI series (X-rays of your esophagus and stomach) that may show reflux, thereby establishing the diagnosis. Medicine such as Prilosec that reduces the production of stomach acid may be necessary.

A further possibility is postnasal drip. When mucus from the sinuses drains down the throat, it can cause a violent, dry cough. Your doctor should be able to see such a discharge by looking into your mouth as you say “aah.”

Show my answer to your doctor and see if he agrees.

Because hiatal hernia (a weakness where the esophagus joins the stomach) is a frequent cause of reflux, I am sending you a copy of my Health Report “Hiatal Hernia.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Dear Dr. Gott: When I take an aspirin, even only one, it invariably upsets my stomach and always makes my left elbow hurt. Why?

Dear Reader: You got me. Any amount of aspirin can cause stomach upset, but I can’t for the life of me explain why your elbow would hurt. You may be experiencing an unusual reaction to the drug. Try using Tylenol as a substitute for aspirin if you need something for pain

Dear Dr. Gott: Please discuss Legionnaire’s disease, its symptoms and treatment.

Dear Reader: Legionnaire’s disease is merely another form of bacterial pneumonia, albeit a recently discovered one. The bacteria (which originally caused infection by contaminating air conditioner ducts in a Philadelphia hotel hosting a Legionnaire convention) can, when inhaled, infect lung tissue, leading to fever, malaise, cough and sputum, and difficulty breathing. Without treatment, this lung infection can be fatal.

The diagnosis is made by X-ray and sputum culture. Prompt use of antibiotics almost always eradicates the infection.