Thread by @Gautaamm

#thread

From a very young age, whenever I would lie down, I would get a dry cough. Occasionally on eating butter chicken at Avishkar (Green Park and Raviraj pale in comparison btw) I would get a burning sensation in my throat.

When I joined dental college in Mumbai, I lived

in the hostel. The food was greasy at best! Occasionally I would get a sore throat and head over to the medical college OPD where I would be prescribed an antibiotic usually Azithromycin. Instead of curing the “Sore Throat” it would make it worse!

Btw we never revealed we lived

in the hostel because they would diagnose it as malaria without even a test and start us on HCQ or something similar! 😂

Then I moved to the US, which I describe as the land of soda (Soft drink) and cheese! When I started practice, the schedule was 9-5 with no fixed lunch break

and often I would munch on chips and Diet Coke (Love it but SOOO bad for you).

The coughing became more frequent and worse! Undisturbed sleep was a dream!

S**t hit the ceiling when one day I had a prolonged coughing bout and I woke up feeling I am going I am throw up my

entire digestive system! My eyes were watering continuously and I was breathless like I was having an Asthama attack. I kept drinking water and it made it worse! Eventually I threw up and I felt immediately better!

I decided right there I need to do something about it!

I had just graduated and started working. The entire country was in the midst of a terrible recession. Taking time off from work is very tough there and seeing a doctor even more difficult.

The earliest appointment I could receive was 2 months away!

I had to address it!

As a dentist, I hate it when patients google something and make a diagnosis. But I had no choice. I decided I will do my own research but totally defer to the doctor!

I googled “Causes of dry cough”.

The Mayo Clinic website is a reliable source and so I clicked on that!

This is what popped up!

By process of elimination, my next search was “Acid Reflux”.

VERY different from what we call “Acidity” here and “Heartburn” in the west!

Given that I checked off most of the symptoms listed, I was 99% convinced that’s what I have!

That led me to what I jokingly call “My PhD thesis”. I read every article there was (kidding) to be read!

I started keeping a daily log of my routine, sleep cycle, food eaten, time at which eaten, symptoms etc.

After 3/4 weeks, I had the following findings.

Basically I had a dry cough the moment I lied down. I also had it during the day around noon and then around 5.30/6.00 pm.

The common factors whenever I had the cough were:
-Sleeping late.
-No breakfast
-Fried food for lunch
-Consumption of Diet Coke
-Eating cheese and Tomato

-Eating Chocolate 😢😢😢
-Not eating on a regular cycle.
-coffee, specially black!
-Body weight.

The changes I made were:
-Sleep on time. As a bachelor living alone, that meant going to bed at 11.00 om instead of 1.00 AM.
-Regular breakfast not involving fried foods

-Carry a fruit which I would eat around the 3 hour mark post breakfast.
-started carrying pre made lunch and eat at a set time
- No cheese, tomato, chocolate and coffee
-Eating dinner night no later than 7.30 PM.
-increased physical activity.

These changes worked like magic.

My cough virtually disappeared, the burning sensation was occasional and my sleep got much better!

I eventually got to a doctor and he was very impressed with what I had done!

Turns out I have what is called as “ACID REFLUX” where the acid basically flows up into the

Oesophagus aka the food pipe. All the factors that I enlisted are contributing factors.

Spicy food is the main cause!

He gave me excellent advice. He said this is a condition and not a transient infection. You never “cure” it you can only manage it. Similar to diabetes!

He explained u need to have a plan ready in terms of medication:

For starters, he explained the difference between preventing it and treating heartburn!

Heartburn is what we call acidity and is the severe burning sensation in your chest and throat area when the Acid Reflux

geta bad!

When that occurs, the only thing that’s going to work is something that will neutralize the acid like
-Tums (Calcium Carbonate),
-PeptoBismol (Bismuth subsalicylate),
-Gelusil (Aluminum and Magnesium Hydroxide and Simethicone)

taken as needed.

He advised me to carry a bottle of Tums with me at all times and take it at the first sign or heart burn!

The most misused antacid in India has to be Omez! It is not a one tablet dose. It is to be taken like an antibiotic!

He said at the first sign of acid reflux, you need

to take a 2 week course or Prilosec (Omez 20 mg) for 14 days on an empty stomach on waking up.

Taking it after you develop a dry cough and wretching does not help!

I have used it on more occasion than one and it’s magical! Whenever I prescribe antibiotics to a patient with

“acidity” I always give Omez 20 mg and advise them to take it for 2 weeks! They all have come back and thanked me for it!

This is what my standard prescription looks like, an antibiotic, an Anti Inflamatory, a probiotic and an antacid!

If you feel an attack of Acid Reflux coming on, characterized by dry cough mainly, the medicine of choice is Zantac (Ranitidine).

If you are going for dinner to a restaurant or a friend where you know the spice and oil levels are going to be high, you can take Rablet 20

preventively.

Lastly, he said, if you are having to take medication on an almost daily basis, we will start you on Nexium daily (Esomeprazole) which a LOT of Americans are on.

And I have a feeling a lot of Indians need to be on!

I have virtually conquered Acid Reflux since

then mainly by lifestyle changes and occasional medication.

I feel a lot of people around me need to see a GI specialist and address this issue!

It pains me when I see friends and family suffer from a dry cough and address it by drinking water (Drives acid further up the

Good pipe) or having some sugar (temp relief in throat).

I hope this thread will help at least a few of you.

Mind you I am not a GI doctor and this is a patient version. Other than lifestyle changes, please consult a doctor before taking any medicine!

#acidreflux #GERD