Can GERD cause respiratory issues?

Question

Hello Doctor,

My 75-year-old father has been dealing with GERD for decades, but now he has developed a chronic cough with increased sputum production and occasional wheezing. His symptoms seem worse at night, and he had a few episodes of fever, which has us concerned about complications like aspiration pneumonia or worsening lung health. Could his GERD be causing these respiratory symptoms, or might it be unrelated? What diagnostic tests or preventive measures would you recommend to address these issues and avoid further complications?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Your father's symptoms can be related to Gastroesophageal reflux disease (GERD). If acid reflux is severe or it occurs at night (when the patient is not conscious) it can cause microaspiration. Gastric acid can enter the airway & causes aspiration pneumonia, reactive airway disease, or chronic cough.

Acid can reach the upper throat & may cause wheezing, coughing, or chronic throat clearing. It's called laryngopharyngeal reflux. GERD can also irritate the vagus nerve, causing wheezing or airway constriction.

However, there can also be some non-GERD-related complications such as chronic obstructive pulmonary disease (COPD) or infection.

Please do the following tests:

1. Chest X-ray.

2. Chest CT scan.

3. Pulmonary Function Tests (PFTs) (to evaluate COPD).

4. Upper Endoscopy (EGD) (to check GERD severity & presence of esophageal strictures or to rule out esophagitis.

5. 24-hour pH Monitoring (for GERD)

6. Sputum Culture (to rule out any infection)

In the meantime he should follow these rules:

1. Avoid trigger foods such as caffeine, chocolate, spicy foods, carbonated drinks, etc.

2. Avoid lying down for three hours after eating.

3. Elevate the head of the bed by six to eight inches.

4. Continue proton pump inhibitors (PPIs).

5. No smoking (zero).

If his symptoms worsen, take him to the nearby hospital as the acid can destroy airway structures & he might need high-flow oxygen.

I hope this information helps you.

Feel free to ask further queries.

Thank you.