I wake up coughing at night and swallow water to relieve this. Please advise.

Question

Hi doctor,

I always wake up coughing during the night. And when I eat, I get discomfort like trapped wind in my esophagus and have to swallow water hard to relieve this. I tested negative for H. pylori and currently on Lansoprazole which is not improving my symptoms much.

Kindly help.

Answer 1

Hi,

Welcome to icliniq.com.

Your symptoms are most likely due to gastroesophageal reflux disease, that is, acid reflux from the stomach to the food pipe in the chest. This happens more in the night hours which results in cough and sleep disturbances. Occasionally, it can also result in bad taste especially of undigested food particles at the rear end of the tongue.

This needs consistent lifestyle and diet modifications as well as medicines.

Avoid heavy meals. Rather prefer small but short interval feeds.
Avoid excess coffee, carbonated drinks, spicy foods and food items which can potentially relax the gastroesophageal sphincter.
Avoid lying down or sleeping in a recumbent position immediately after having food. Rather have an early dinner and give an interval of one to two hours before you sleep.
Keep the head end of the bed elevated (30 to 45 degrees) during sleep.

Regarding medicines, I suggest you add prokinetics like Domperidone (10 mg) or Ondansetron (8 mg) three times a day. You will need to continue this consistently for six weeks and see the response. I would like to have a look at your endoscopy report. You can send across the same when you review. Consider a review after four weeks.

I hope this helps.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

One of the two tablets I have mentioned will suffice.

All the best.

Answer 3

Hello,

Welcome back to icliniq.com.

You can try getting medicines after consulting local GPs. Please consider sending the endoscopy, ultrasound and other reports too.

I hope this helps.

Thank you.

Answer 4

Hello,

Welcome back to icliniq.com.

No herbals, please. I would say a big 'no' to those.

Domperidone is a relatively safe drug. Take it for three weeks.

Thank you.