Cough and throat clearing

Symptoms

Cough and throat clearing

Whilst occasional coughing or throat clearing is natural, persistent and excessive coughing may warrant further examination. If you are experiencing frequent coughing, soreness in the throat, or hoarseness without displaying symptoms commonly associated with the common cold or influenza, it is plausible that stomach acid may be irritating your vocal cords, airways, or throat. It is recommended to seek professional evaluation from one of our specialists.

Please continue reading to comprehend the various origins of persistent coughing and throat clearing.

Related Symptoms

  • - Acid reflux (heartburn) and indigestion
  • - Hoarseness of voice
  • - Swallowing Problems

Causes of chronic cough and throat clearing

Persistent coughing and throat clearing may arise from complications in your digestive tract. Nonetheless, other conditions such as asthma could also instigate your symptoms. Please peruse the ensuing list to discern the potential causes correlated with your digestive system.

Acid Reflux

Rising stomach acid causes acid reflux. You may feel sharp discomfort in your chest or throat, or you may have ‘silent’ reflux (LPR) – which causes no chest symptoms.

  • - Bad breath
  • - Bitter taste in your mouth
  • - Bloating
  • - Nausea

Barrett’s Oesophagus

Compromised oesophageal lining can culminate in Barrett’s oesophagus, generally resulting from acid reflux.

Acid reflux is a principal symptom of Barrett’s oesophagus and may provoke inflammation in the throat, eventually leading to persistent coughing and throat clearing.

Signs of Barrett’s encompass the following :

  • - Recurrent Heartburn
  • - Dysphagia
  • - Regurgitation

GORD/ GERD

Gastro-oesophageal reflux disease (GORD) ensues from regular acid reflux, which is attributed to a weakened or relaxed sphincter. Individuals with increased vulnerability to GORD include those who are pregnant, overweight, or possess a hiatus hernia.

GORD exhibits similar indications to acid reflux, albeit with greater severity. Symptoms may include distension, eructation, halitosis, and oesophagitis. Heartburn, which is typically experienced more frequently than with acid reflux, is a prevalent manifestation amongst individuals diagnosed with GORD, often transpiring several times a week.

EoE

Eosinophilic oesophagitis (EoE), also referred to as oesophageal asthma, is an infrequent ailment causing chronic inflammation in the lining of the oesophagus, with the possibility of developing oesophageal strictures.

EoE could provoke symptoms like dysphagia, thoracic discomfort, and a sensation of food impeding your chest or progressing sluggishly down your oesophagus.

Swallowing Problems

Dysphagia, characterised by difficulties in swallowing, could cause irritation in your oesophagus, leading to persistent coughing or throat clearing. One possible cause of dysphagia is achalasia.

Dysphagia indications include regurgitation, mastication complications, and salivation.

Functional Cough and Throat Clearing

It is a condition that involves heightened sensitivity of the neural receptors in the throat, leading to an incessant urge to clear the throat. Though harmless, an accurate diagnosis and treatment could be acquired by consulting with an expert in the field.

Other causes include:

  • - Nasal allergies
  • - Anxiety disorder
  • - Tourette’s syndrome
  • - Medication side effect
  • - Lung conditions, such as asthma, COPD, and bronchiectasis

Diagnosis

Upon initial consultation, we will meticulously inquire about the symptoms you are experiencing, their frequency, and the presence of any known triggers to establish the cause of your chronic cough and throat clearing. Subsequently, we will carry out several tests, the selection of which will depend on the underlying condition we suspect.

Some of the tests we may conduct are as follows:

  • - Barium swallow: allows us to view your upper gastrointestinal tract
  • - Laryngoscopy: to visually inspect your throat and larynx (voice box)
  • - Bravo capsule pH test: measures the acidity of fluid rising in your oesophagus
  • - Bravo capsule pH test: measures the acidity of fluid rising in your oesophagus
  • - 24-hour pH impedance test: measure the amount of fluid, as well as acidity in the oesophagus
  • - High-resolution oesophageal manometry: to see whether all the muscles and valves of the oesophagus are working properly

To obtain a clearer view of your upper gastrointestinal (GI) tract and identify the cause of your symptoms, we may recommend an endoscopy.

If we suspect that your symptoms may be caused by a nasal allergy, we might advise you to undergo allergy testing.

Following the diagnosis of the underlying cause of your symptoms, we will suggest appropriate treatment options.

Treatment

The recommended treatment for your cough and throat clearing will vary depending on the underlying cause. If a digestive issue is not suspected, we may refer you to another specialist such as an ear, nose, and throat (ENT) or respiratory doctor to rule out any potential lung conditions.

Home remedies for a cough and throat clearing include:

  • - Changes to your diet, such as following a Mediterranean diet
  • - Avoiding cow milk
  • - Elevating the head of your bed by 30 degrees or more
  • - Honey tea, or similar
  • - Drinking plenty of water
  • - Antihistamines to counter a potential allergic reaction
  • - Stress relief methods
  • - Sugar-free cough drops
  • - Cutting down on, or quitting, smoking and drinking alcohol

If the simple at-home remedies fail to alleviate your symptoms, we recommend scheduling an appointment with one of our specialists. Based on the severity of your condition, we may prescribe medications or recommend non-surgical or surgical procedures, such as Stretta therapy or endoscopic dilatation. Our recommendations will depend on the underlying cause of your symptoms.

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Chest-Pain

Chest pain and discomfort

Symptoms

Chest pain and discomfort

Chest pain and discomfort can frequently be attributed to digestive issues, rather than cardiac problems. Non-cardiac chest pain is the medical term for chest pain that does not originate from the heart. Conditions such as acid reflux can generate a sharp, agonizing sensation in the chest. If you experience symptoms such as shortness of breath or chest tightness, it is important to seek emergency medical assistance.

Our gastroenterologist possesses the expertise necessary to identify whether your chest pain or discomfort is due to digestive issues.

Related Symptoms

  • - Abdominal pain
  • - Acid reflux (heartburn) and indigestion
  • - Belching and Burping
  • - Hoarseness of voice
  • - Swallowing Problems

Is your chest pain an emergency?

Seek immediate medical advice for the following symptoms:

  • - Tightness in the chest
  • - Shortness of breath
  • - Pain that spreads and doesn’t go away after a few minutes

These are signs of a heart attack and require immediate assistance. If you experience these symptoms, call 999 or go to the nearest emergency room.

Chest pain symptoms caused by digestive problems

While it isn’t always clear what is causing your chest pain and discomfort, some key signs would indicate your pain is due to a digestive problem rather than a heart problem. 

Signs include:

  • - Chest pain after eating
  • - Pain in your chest while you eat
  • - Accompanied with digestive symptoms

If you experience the following digestive symptoms alongside your chest pain, it suggests your pain is due to a digestive problem. Though, you should discuss your symptoms with a doctor to rule out other causes of your chest pain first.

Symptoms that could indicate digestive problems include :

  • - Hiccups
  • - Abdominal pain
  • - Constipation
  • - Nausea and vomiting
  • - Belching and burping
  • - Hoarseness of voice
  • - Swallowing problems
  • - Acid reflux (a burning sensation in your chest)
  • - Blood in your stools, stools may be dark or black

Causes of non-cardiac chest pain and discomfort :

Acid reflux, heartburn and indigestion

Acid reflux often causes a burning sensation in your chest, known as heartburn. You may also experience an unpleasant taste in your mouth. Individuals with indigestion (dyspepsia) will often feel uncomfortably full after eating and may feel sick (nausea) and bloated.

Gastro-oesophageal reflux disease

Gastro-oesophageal reflux disease (GORD) refers to excessive acid reflux. Acid and bile flow up from the stomach via the food pipe (oesophagus) due to a relaxed or weak sphincter. Left untreated, this can lead to Barrett’s oesophagus, which has similar symptoms to acid reflux. GORD is the most common reason for non-cardiac chest pain.

Irritable bowel syndrome (IBS)

IBS usually causes abdominal pain, though it may also cause pain in your chest, back, and jaw. For people with IBS, trapped gas often causes chest pain.

Functional dyspepsia

Functional dyspepsia is a medical condition characterized by persistent symptoms of indigestion without a clear underlying cause. Symptoms of functional dyspepsia may include a burning sensation in the lower chest, bloating, nausea, and belching.

 

Swallowing disorders

Swallowing disorders are medical conditions that affect the food pipe or oesophagus, resulting in difficulty swallowing. Pain along the oesophagus, which can be felt in the chest and other areas, may also be experienced. Such conditions may include achalasia or oesophageal spasm.

 

Additional digestive conditions that can cause non-cardiac chest pain

Below we list other conditions that cause chest pain and discomfort and where you are likely to feel that pain.

  • - Acute cholecystitis (Gallbladder inflammation) – upper chest pain on the right side
  • - Other gallbladder problems – possibly lower or upper chest pain on the right side
  • - Oesophageal hypersensitivity – higher chest pain coming from the throat area
  • - Oesophageal rupture – sudden, severe chest pain*
  • - Large hiatal hernia – lower chest pain
  • - Peptic ulcers – recurring discomfort
  • - Pancreatitis – lower chest pain

When to speak to a gastroenterologist :

After a cardiac condition has been excluded by your physician, alternative causes may be explored. If additional gastrointestinal symptoms, such as those aforementioned, are present, it would be prudent to consult with a gastroenterologist.

Our team of gastroenterologists will request a comprehensive account of your symptoms, their duration, and degree of severity. Moreover, we will delve into your medical history and that of your immediate family to deduce the most plausible causes.

Diagnosing non-cardiac chest pain

Primarily, it is imperative to establish the underlying cause of the discomfort before determining an appropriate treatment course. We can administer a variety of examinations to diagnose the source of the pain, such as an endoscopic investigation to scrutinize your oesophagus and upper gastrointestinal (GI) system.

Furthermore, other evaluations that may be conducted include:

  • - Barium swallow
  • - Laryngoscopy – If the pain extends to your throat
  • - Video fluoroscopy – If you are also experiencing trouble swallowing

Treatment

For a multitude of conditions that elicit thoracic pain and discomfort, we generally initiate lifestyle modifications to gauge the impact on your symptoms.

If there is an improvement in your symptoms, we may opt for monitoring your condition. Conversely, if no alteration or exacerbation is observed, pharmaceutical intervention may be prescribed. In cases of acute symptoms, alternative treatments may be recommended, contingent on the underlying cause of the condition.

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blood in your poo

Blood in your Stool

Symptoms

Blood in your stool

Noticing blood in your stool can be a cause for concern. While there are various minor factors that can contribute to this, it can also indicate the presence of a gastrointestinal (GI) ailment. It’s important to note that in some rare instances, it may be indicative of cancer.

This article will help you understand :

  • - When to seek urgent care
  • - The signs of blood in your poo
  • - The causes
  • - How we diagnose the cause
  • - Treatment options

If you notice any blood in your stool, it’s recommended to consult with your doctor. In cases where there are no accompanying symptoms, it may not necessarily be an urgent matter, but it’s still advisable to seek medical attention for further investigation.

Related Symptoms

  • - Abdominal pain
  • - Bloating
  • - Diarrhoea
  • - Nausea and vomiting

When to seek urgent care

Although the presence of blood in your stool usually doesn’t necessitate immediate medical attention, there are some situations where seeking urgent care is warranted.

Signs to seek urgent care:

  • - Have a fever
  • - Rapid, shallow breathing
  • - Sudden bloody diarrhoea
  • - High volumes of blood lost
  • - Feeling lightheaded/ weak
  • - Severe abdominal pain or cramping

What does blood in your poo look like?

The presence of blood in your stool indicates bleeding in some part of your digestive system. This condition is commonly known as rectal bleeding, which refers to bleeding from the rectum or anus.

You might experience:

  • - Blood on your toilet paper
  • - Red streaks on your poo (stool)
  • - Pink toilet water (blood in the toilet bowl)
  • - Bloody diarrhoea or blood in your poo
  • - Black, tarry poo

Symptoms associated with blood in your poo :

  • - Fainting
  • - Confusion
  • - Tar-like poo
  • - Rectal pain or pressure
  • - Feeling lightheaded or dizzy

The colour of the blood in your poo signals where the blood is coming from in your digestive tract. It could be bright red, dark red, or black and tarry. The colour of your poo may also change due to harmless reasons, such as the food you ate. High quantities of beetroot, for example, may turn your poo red.

Bright red

If the blood in your poo is bright red, it has likely come from low in your colon or rectum. The rectum is the last part of your colon/large intestine.

During pregnancy or postpartum, it’s possible to develop hemorrhoids or an anal fissure due to elevated pressure on blood vessels in the lower abdomen. These conditions are typical during and following pregnancy.

Causes of bright red blood in your poo include :

  • - Diverticular disease (may also cause dark red or black blood)
  • - Anal fissure (a small tear in the lining of your bottom)
  • - Broken blood vessels in the gut
  • - A side effect of medication
  • - Haemorrhoids (piles)
  • - Inflammatory Bowel Disease (IBD)
  • - Severe gastroenteritis (usually caused by food poisoning
  • - Bowel cancer

Dark red/maroon

If the blood in your stool is dark red or maroon in color, it suggests that the bleeding is occurring further up in the colon or small intestine. There is also a possibility that it is originating from the stomach.

Causes of dark red blood in your poo include :

  • - Diverticular disease – may also cause bright red blood
  • - Bleeding in your stomach or gut
  • - Bowel cancer (less common)
  • - Stomach ulcer

Black and tarry

Very dark red and black poo suggests the bleeding is coming from your upper digestive tract. This can range from your mouth and food pipe (oesophagus) to your stomach and upper small intestine (duodenum).

Generally, the darker the blood, the higher the source of the bleed. If you are bleeding from your stomach, your poo may appear plum or black and tarry. Your blood might also look sticky.

Iron tablets can cause black poo, as can eating a lot of dark foods. If you are taking iron tablets, speak to your doctor about the possible side effects.

Occult (hidden) blood

For some people, we can only identify the presence of blood in their poo using a stool test.  This is a test of your poo to look for microscopic traces of blood. If the blood is present but not visible, we call this occult. 

We may perform stool tests if you are experiencing symptoms of a GI condition. Such as a change in your bowel habits or abdominal pain.

Causes of occult blood include :

  • - Ulcers
  • - Bowel cancer
  • - Haemorrhoids
  • - Diverticular disease
  • - Inflammatory bowel disease (IBD)
  • - Polyps on your colon lining or rectum

Polyps and Bowel Cancer

Blood in your poo is rarely caused by bowel cancer or polyps (abnormal growths). It’s still important to be aware of the signs.

Polyps and Bowel Cancer

  • - Losing weight
  • - Pain in your abdomen
  • - Tiredness (fatigue)
  • - Breathing problems
  • - Frequently feeling as if you need to poo
  • - Looser bowel movements or constipation
  • - Change in bowel habits, such as more frequent bowel movements

Diagnosis

If we believe your symptoms are due to a GI condition, we may perform the following tests.

  • - Stool test
  • - Abdominal scan
  • - Complete blood count
  • - Digital rectal examination
  • - Endoscopy – commonly a colonoscopy, though you may need a sigmoidoscopy or gastroscopy

Whether we perform an endoscopy will depend on your symptoms.

Treatment

How we treat blood in the poo depends on what is causing it.

Possible Treatments :

  • - Lifestyle changes
  • - Medication
  • - Endoscopic treatment
  • - Surgery

If you are experiencing an anal fissure or haemorrhoids, we may recommend a high-fibre diet and other lifestyle changes. If we find signs of an infection, we may prescribe antibiotics.

Endoscopic treatment may be appropriate if the bleed does not stop. This could involve injecting medicine, cauterising the site of the bleed, or closing off a blood vessel.

If your colon has been damaged by diverticula, IBD, or cancer, we may recommend surgery to treat this.

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What is Acid reflux?

Symptoms

What is Acid Reflux

Acid reflux, also known as gastroesophageal reflux disease (GERD), is a condition in which stomach acid flows back into the esophagus, causing heartburn and other symptoms. The esophagus is the tube that connects the mouth to the stomach.

In a normal digestive system, a ring of muscle at the bottom of the esophagus called the lower esophageal sphincter (LES) opens to allow food and liquid to flow into the stomach, and then closes to prevent the contents of the stomach from flowing back into the esophagus. However, in people with acid reflux, the LES is weak or relaxed, allowing stomach acid to flow back into the esophagus.

Common symptoms of acid reflux :

  • - Heartburn
  • - Regurgitation
  • - Chest Pain
  • - Difficulty swallowing

If left untreated, acid reflux can cause damage to the esophagus and increase the risk of developing other health problems, such as esophageal cancer.

Treatment for acid reflux may include lifestyle changes, such as avoiding trigger foods and losing weight, as well as medications to reduce acid production and heal the esophagus. In severe cases, surgery may be recommended to tighten the LES and prevent acid reflux.

If you are experiencing symptoms of acid reflux, it is important to consult with a healthcare provider for an accurate diagnosis and appropriate treatment plan.

HOW CAN I CURE ACID REFLUX WITHOUT MEDICATIONS ?

There are several lifestyle changes that can help to reduce the symptoms of acid reflux and avoid the need for medication:

  • - Lose weight: Extra weight puts pressure on the stomach and can cause acid to leak back into the esophagus.
  • - Avoid trigger foods: Common trigger foods include citrus, tomato-based products, chocolate, alcohol, caffeine, fatty and fried foods, and spicy foods.
  • - Eat smaller, more frequent meals: Eating smaller, more frequent meals instead of three large meals can help to reduce the amount of pressure in the stomach and reduce the risk of acid reflux.
  • - Avoid eating close to bedtime: Eating a large meal close to bedtime can cause acid to flow back into the esophagus while lying down.
  • - Avoid tight-fitting clothing: Wearing tight-fitting clothing can put pressure on the stomach and increase the risk of acid reflux.
  • - Raise the head of your bed: Elevating the head of your bed can help to prevent acid from flowing back into the esophagus while you sleep.
  • - Practice relaxation techniques: Stress and anxiety can increase the risk of acid reflux, so practicing relaxation techniques such as deep breathing, meditation, and yoga can be helpful.
  • - Chew gum: Chewing gum can help to increase saliva production and neutralize stomach acid.
  • - Drink herbal tea: Drinking herbal tea, such as chamomile or fennel, can help to soothe the digestive system and reduce symptoms of acid reflux.

It’s important to note that these lifestyle changes may not work for everyone, and some people may still require medication to manage their symptoms. It’s always best to consult with a healthcare provider to determine the best treatment plan for you.

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