If you have a cough for less than eight weeks, it is most likely to be due to a virus that can cause an upper respiratory tract infection. But what if your cough persists and becomes chronic?

If a chest X-ray shows no abnormality, often the most common, yet unexpected, cause of chronic cough is reflux.

Muriela Clark, age 69 and living in the UK, suffered from continual coughing – particularly at night – for 12 years before she was diagnosed with reflux.

She explains: “My cough started one day with an irritating dry tickle when I was in my fifties and my GP prescribed inhalers. For a time the inhalers did seem to provide some relief but over the years it was noticeable that I had developed a clear mucus-producing cough that was particularly bad during the night and if I caught a cold it was a nightmare.”

“After continual coughing all night, I would start the day totally exhausted. The continual pressure from coughing also caused lower back and abdominal pain and resulted in me undergoing an incisional hernia procedure.”

Muriela underwent various tests with specialist consultations including sinus scans, hearing tests, allergy tests, voice therapy and respiratory tests, which showed evidence of hypersensitive upper airways.

She had a gastrointestinal endoscopy which showed she had a loose lower oesophagus sphincter (LOS), the valve that is designed to keep stomach contents from going into the oesophagus and the throat, and a pH Monitoring Test also identified the presence of reflux as well as a small hiatus hernia but Muriela says she was told this was insufficient to suggest any further action.

It was during a discussion with a medical professional in Switzerland that Muriela discovered Peptest, a non-invasive test used by leading medical consultants worldwide to diagnose reflux with their patients.

Using Peptest, samples of saliva are taken at different times during the day and tested for the presence of the stomach enzyme pepsin. Because pepsin should only be found in the stomach, if it is found in saliva samples it indicates that you are suffering from reflux. The concentration in a saliva sample is measured to show the severity of reflux and to provide information on when you are likely to reflux.

“Using Peptest, the high levels of pepsin in my saliva confirmed I was refluxing but also the levels involved and when it was happening,” says Muriela. “With this information, I was able to work with my GP to positively manage my reflux symptoms and to identify the best treatment.”

“Because I was coughing a lot at night, I now take Gaviscon Advance before I go to bed as I was advised that this acts as a raft at the top of your stomach and suppresses reflux and prevents gastric contents leaking into the oesophagus. My experience after a few days was that this certainly calmed things down and I wasn’t coughing as much.”

“I also found it was important to raise the upper body particularly before going to sleep and I don’t retire to bed until at least three hours after eating or consuming liquid. I have identified food which can trigger my symptoms, including chocolate, caffeine in tea and coffee, fatty foods and acidic fruits and drinks including wine and fizzy drinks.”

“I wish I had known about Peptest at the beginning of my long journey of discovery, instead of experiencing long waiting times for various forms of invasive, time-consuming and expensive procedures including endoscopy and pH monitoring.”

“I could have at least eliminated reflux as a cause of my cough or had confirmation, as I now know that reflux does seem to be one of a few contributing factors to the cough. Having evidence-based results would have enabled me to consider the next options with my medical practitioner instead of leaving things so long.”