Basically, the body eliminates foreign material by coughing. The cough may be due to dust, mold, vapors from spray cans, dusting powders, perfumes and a host of other irritants that might be in the air. But there is one cough that is caused by a condition that is often overlooked.

Mrs. A came to my office complaining of a chronic cough causing her to awake during the night. The cough was persistent, unrelenting and nonproductive. She had been to several physicians and drugstore pharmacists, who had prescribed everything to eliminate the cough. She tried cough drops, cough syrups and even prescribed medication containing codeine, all to no avail. At this point, she was desperate and had even removed the dust-laden rugs from her floors. She denied using any types of aerosol sprays, burning incense or spraying perfumes in her room. She had even changed her feather pillows to Dacron.

Out of desperation, Mrs. A had even bought a new mattress, fearing that she was allergic to dust mites, usually found in old mattresses. Without a doubt, Mrs. A was tired of being tired due to her chronic nonproductive cough.

Upon further questioning, she related that she occasionally experienced a burning in her chest that radiated to her jaw. Electrocardiograms revealed a normal heart. However, she had been given nitroglycerin, which only caused her to experience headaches and offered no relief from the chest discomfort. During our conversation, she related that she did experience chest pain after eating chocolate. This small piece of medical history caused the bell to ring in my head.

Upon further questioning, it was evident that she was possibly experiencing a cough due to 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. However, upon entering the esophagus, it can produce chest pain. The acid creeps up the esophagus into the throat, often entering the lungs through the windpipe, which is located close to the esophagus. The acid can produce a chronic cough that is not responsive to cough medicines.

Mrs. A was instructed to raise the head of her bed and eliminate caffeine beverages, alcohol and chocolate from her diet. She was given a prescription to help reduce the production of stomach acids.

Mrs. A now sleeps soundly through the night without a cough. She is only occasionally bothered by her cat, who sleeps at the foot of her bed.