Brief Answer:
Gastroesophageal reflux disease

Detailed Answer:
Hello Mr. XXXX,
Thank you for your query.
I'm Dr. Shuba Hariprasad and will be answering your query today.

Would you please clarify a few things for me?
1) are you overweight or have a large abdomen?
2)do you smoke or consume too much alcohol?
3)do you have any history of heart burn or gastritis?
4)do you lie down or sit right after a full meal? Or Consume a lot of water during or right after meals?
5) any history of Hiatal/diaphragmatic hernia?
6)any history of diabetes, hypertension, heart disease in your or your family medical history?

Based on your query I would primarily like to rule out gastroesophageal reflux disease (GERD).
The esophagus /food pipe connects to the stomach through a sphincter valve that is maintained at a certain pressure to allow food to pass into the stomach and prevent regurgitation of stomach contents.
When this valve loosens (due to obesity, high pressure from eating full stomach /vomiting/Hiatal hernia, improper habits like sleeping after large meals), the stomach acid can leech back in to the esophagus and all the way upto your throat to cause irritation and cough.
This condition is chronic. Symptoms can be minimized and disease progression can be prevented by lifestyle modifications.
Coughing usually only occurs in bouts, pronounced after meals or on waking up or after having specific types of food (spicy, oily, Caffeinated, sugary). This can continue for a minute or two and leave you breathless.
I recommend that you have a CT abdomen to rule out Hiatal hernia and an endoscopy for the GERD.

I suggest :
-smaller and more frequent meals.
-chewing your food very well which aids digestion.
-quitting smoking
-stop alcohol at least till symptoms resolve.
-not to lie down after a meal or sit with your stomach compressed. A 30 degree reclining position will be ideal.
-avoiding culprit foods. Maintain a diary of the foods you eat and when your symptoms of occur.
-general physical exam to check your lungs, cardiovascular, liver and kidney function. (if not already done)
This would involve blood tests (complete blood count, Esr, lipid profile, blood glucose panel, kidney & liver function tests), an urine analysis, an ultrasound of the abdomen, an electrocardiogram, an echocardiogram, chest xray and Spirometry.


Hope this helps and I've answered your query.
Please let me know if there is anything else I can help you with.

Wish you good health,
Regards,
Dr. Shuba Hariprasad

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Brief Answer:
GERD/bronchospasm

Detailed Answer:
Hello,
Thank you for the follow up.

I guess it does sound like a whole lot of tests. I should have been more specific about their necessity. However, most of them were suggested as a means of general check up to monitor your overall health. (to detect diabetes, heart problems, hypertension and related pathology). It is optional

A Hiatal hernia is a hernia that occurs through a defect in the diaphragm. The diaphragm is a muscular structure that separates the abdomen form the chest cavity. There may be muscle defects in it that allow the abdominal organs to push in to the chest cavity.
This, if present, may apply pressure on the gastroesophageal junction and result in GERD.
There may be some rawness to the throat but the only way to confirm this is by having an upper gastrointestinal endoscopy done.
A positive history of heart burn or gastritis is usually present.

A healing juice does sound tempting ☺. However it is possible to make a difference in your symptoms by trying out my suggestions, mentioned in my previous reply.
Few more suggestions :
-Milk is a natural antacid. Having cool milk, about 100 ml may help neutralize acid
-have half a cup of warm water with 1 teaspoon of good quality honey just before bed. This coats the throat and keeps it moist
-use a humidifier if air in your bedroom is too dry.
- Direct airconditioner vent away from you.
- avoid water during a meal and for a half hour layer. Only small sips if required.


You had mentioned antibiotics helping back in January. Why were they prescribed? Was it for the same kind of cough? Did you have respiratory tract infections at that time? Do you have asthma? Allergies?
Bronchospasms (due to allergies or recent respiratory infection) can also cause coughing fits. This would be detected by auscultating (listening to) the chest with a stethoscope.

I suggest you try the lifestyle changes I suggested. I completely support the preventive and natural therapy measures. Try these for a month.
If it worsens or persists, see your physician to rule out the above and treat accordingly.

Hope this helps and I've answered all your queries.
I'd be happy to help you with any other questions you may have.

If not, please close this discussion and rate my answer.
Wish you good health
Regards,
Dr. Shuba Hariprasad

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Brief Answer:
Hiatal hernia may have subtle symptoms.

Detailed Answer:
Hello Mr. XXXX,
Thank you for the follow up.

Significant Hiatal hernia is usually symptomatic. Smaller ones may cause subtle symptoms.
As you are tall, symptoms may be subtle even if a moderate sized hernia is present.
Please try my suggestions. The amount of wine you consume is safe and may even aid in digestion.
One more suggestion I'd like to add is to avoid drinking cold water, especially during meals. If you have to have it cold, keep it in your mouth till it warms up (reaches the temperature in your mouth) and then swallow.
You have made wise diet modifications. Please continue them.
Eating whole grains, fresh fruits and vegetables, seeds, nuts with adequate water intake can help reduce LDL (bad cholesterol) and increase HDL (good cholesterol).

I hope you find a resolution by trying these tips.
It would be great to have a feedback in month or so.
Please let me know if there is anything else I can help you with.
If not, please close this discussion and rate my answer.

Best wishes
Regards,
Dr. Shuba Hariprasad

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