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DJ2017
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Quote DJ2017 Replybullet Calendar Event: Persistent chronic cough
    Posted: 04áJaná2018 at 4:09pm
Hi Admin and fellow members. This is my first post and I look forward to learning more about Barrett's which, for me, was diagnosed one year ago. I have one rather urgent question at the moment. Following a head cold I have developed a persistent, chronic cough which features wretching and gagging quite frequently. As I have suffered coughs before which have followed episodes of acid reflex, I am presuming that this one is related to my Barrett's. However, as there is very little said about chronic coughs and Barrett's I am wondering whether it is actually nothing to do with Barrett's. Any thoughts ?
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chrisrob
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Quote chrisrob Replybullet Posted: 04áJaná2018 at 4:54pm
Hi DJ,

Chronic cough is not to do with Barrett's, which is asymptomatic, but may be from the reflux that was a contributory factor to your developing Barrett's.

In 2014 a survey revealed 64% of refluxers reporting chronic cough. A more extensive 2017 survey showed amongst those whose reflux was not sufficient to merit daily acid supressants, 27% had chronic cough. Of those whose acid reflux was worse and therefore took daily acid suppressants, 47% had chronic cough.
For the worst refluxers, who went on to be treated with anti reflux surgery, 50% report chronic cigh prior to surgery reducing to 19% post surgery.
It is a consequence of aspiration of extra-oesophageal reflux: contents from the stomach reflux into the oesophagus, travel full column and, breaching th eupper oesophageal sphincter, may aspirate into the respiratory system. (See this chapter in the Down With Acid book.)

For me the chronic cough was the worst. I experienced reflux all my life recalling incidents from the age of 4. It wasn't until I was 60 and had a fundoplication, the reflux symptoms stopped. However, L believe a lifetime of coughing has caused lung damage and I am due for a pulmonary function test tomorrow.

Even top doctors (and I include in this an internationally well renowned gastroenterology professor from Cambridge with whom I discussed this last year) don't separate acdi from reflux. They are two different (yet connected) actions. Acid suppressants like PPIs are excellent at reducing acid but ineffective at reducing reflux. The common approach when reflux symptoms such as cough are increasing, is to ineffectively increase the dose of your medication. Reflux needs to be controlled by lifestyle modification where possible and surgery if necessary.
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DJ2017
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Quote DJ2017 Replybullet Posted: 04áJaná2018 at 5:29pm
Chris - thank you so much for your speedy and comprehensive reply including your linked information. It is sometime since I experienced Extra-Oesophageal Reflux, which had prefaced periods of coughing in the past which is why I questioned what my current chronic coughing was due to. I was tempted to raise my daily level of omeprozole from 20mg to 40 mg but my doctor (a locum who did not know me) said today I should not do this and gave me a Salamol inhaler, which I have yet to try, to reduce the coughing. I also have a cough linctus, lozenges and paracetamol. Anyway, thank you again for your time and I look forward to sharing information/experiences/knowledge with you and others.
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chrisrob
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Quote chrisrob Replybullet Posted: 04áJaná2018 at 5:54pm
I was on inhalers for a while but they were ineffective. In the past I've had all sorts of tests - including for allergies etc.

Although my fundoplication cleared up my chronic cough previously, it is coming back but doesn't feel like reflux.
For the last year, I've been tired all the time (TATT) and getting short of breath on exertion (SOBOE).
(Those who know me know I'm a keen cyclist having cycled through France, Holland, Vietnam, Cambodia, Myanmar and over the Andes but TATT & SOBOE have stopped that and I have had to succumb to an electric bike.)
I did eventually see a GP in September after having had to wait 8 weeks (and it wasn't one I knew). I think my returning cough etc is due to lung damage from the years of reflux. When I said this t the GP he said, "Reflux doesn't cause lung damage!" (I referred him to my book.)

When I eventually convinced him he said he'd refer me to be seen within 4 weeks. After hearing nothing, I checked with the hospital. He'd only requested a "routine appointment" (normally 18 weeks wait) instead of an urgent referral. Rather than wait 8 weeks for another GP appointment to get that changed, I accepted the earliest date I was offered to get on the system in case there was a cancellation. I am now having a lung function test tomorrow and a clinic appointment next week So we'll see and I'll let you know.
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DJ2017
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Quote DJ2017 Replybullet Posted: 04áJaná2018 at 5:55pm
Thanks Chris and good luck tomorrow.
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roganhen
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Quote roganhen Replybullet Posted: 19áJaná2018 at 12:41pm
Hi DJ,
I too have Barretts and have a persistent cough after a mild virus. This happens with some viruses and a few years ago my GP informed people that it is just an annoying aftermath of a slow burning infection and 'after a few weeks you will one day realise that it has cleared up.'
However such a cough is also a warning sign for people like us and should be monitored.
If the cough is productive and can be associated with a bit of sinus drainage it is most likely post viral but it is really difficult to be sure.
I feel that my cough is following the cold and it would be a bit coincidental to be associated with the reflux so I am going to give it a few weeks to settle down.
If it goes on too long I'll think again.
Good luck,
Roganhen
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