Mrs. A came to my office complaining of a chronic cough that was causing her to wake up at midnight. The cough was persistent, unrelenting and nonproductive. She had been to several physicians who prescribed everything from a cough drop to cough syrups containing codeine-all to no avail.
At this point, she was desperate and had even removed dust-laden rugs from her floors. She denied using any type of aerosol spray, burning incense or spray perfumes in her room. She had even changed her feather pillows to non-allergenic Dacron.
Out of desperation, Mrs. A had even bought a new mattress, fearing that she was allergic to mite dust, which is usually found in older mattresses. Without a doubt, Mrs. A was tired of being tired due to the chronic, nonproductive cough.
Upon further questioning, she related that she occasionally experienced a burning chest pain, which radiated to her jaw. EKGs revealed a normal heart. However, she had been given nitroglycerin, which only caused her to experience headaches and gave her no relief from the chest discomfort. She related further that she experienced chest pain after eating chocolate, sucking on peppermint candies and even drinking a cup of coffee at bedtime. This small piece of history caused a bell to ring in my head.
On further questioning, it was evident that she was experiencing a condition known as reflux esophagitis, which simply means that the acid from her stomach entered her food tube, known as the esophagus.
This acid, which is produced in the stomach, does a great job as long as it remains in the stomach. Upon entering the esophagus, however, it produces chest pain. The acid creeps up the esophagus into the throat, often entering the lungs during sleep, causing an explosive cough.
Mrs. A was instructed to raise the head of her bed; told to eliminate caffeine, alcohol and chocolate from her diet; and was prescribed a medication to help reduce the production of stomach acids. Mrs. A now sleeps soundly through the night, only occasionally bothered by her cat sleeping at the foot of her bed.
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