I have reflux and one of the symptoms is a cough, so how do I tell the difference between this and the cough caused by COVID-19?

If we cough a few times at the moment, it’s hard not to think it may be related to the coronavirus.

COVID-19 is a lower respiratory tract infection, which means that most of the symptoms are felt in the chest and lungs.

The coronavirus cough

One of the main symptoms of coronavirus is a new, continuous dry cough. This means coughing a lot for more than an hour, or three or more coughing episodes in 24 hours.

The cough comes on fast and is continuous while the infection remains, with many patients reporting they can feel it deep in their chest and find it difficult to breathe.

A dry cough is also where no phlegm or mucus is produced, which is also irritating and usually associated with a tickly throat.

DID YOU KNOW… The Embedded Systems Laboratory (ESL) at EPFL university in Switzerland is aiming to leverage signal processing, pervasive computing, and machine learning to develop an app that will listen to people cough and use artificial intelligence to determine whether they sound like a coronavirus patient. Researchers claim that COVID-19 patients have a cough with a distinctive sound — a chirping intake of breath at the end — that differed from other illnesses. Read more about the app here.

The reflux cough

However, a cough associated with reflux is a chronic cough which you are likely to have had for several months even years.

Reflux is a condition in which the stomach contents leak backward from the stomach into the oesophagus (food pipe) and even into the airways.

Research has shown that reflux cough usually diminishes at night as the valve at the bottom of the oesophagus closes during sleep, but the cough often stops you getting to sleep at night. The cough then reoccurs in the morning, frequently as you get up (the valve opens to allow for belching).

The cough is also precipitated by meals, particularly on swallowing dry food or shortly after the meal has finished. Reflux/chronic cough is also very apparent following aspiration, exercise and walking.

The reflux that causes respiratory issues, such as a cough, can be a gaseous mist that is weak acid or even wholly non-acid. This explains why proton pump inhibitors are often an ineffective treatment for chronic cough.

Treating reflux cough

Treatment for reflux cough takes two forms: blocking the stomach acid, which is successful in about half of the cases, or actually preventing the reflux wave, the most common method of prevention being the use of alginates, as present in Gaviscon products.

Treating coronavirus cough

According to guidelines by the National Institute for Health and Care Excellence (NICE), COVID-19 patients with cough should avoid lying on their back and try simple measures at first, such as taking honey.

NICE also says medical professionals should consider codeine linctus, codeine phosphate tablets or morphine sulfate oral solution to suppress coughing if it is distressing.

Getting help

If you have symptoms of coronavirus, such as a high temperature, a new, continuous cough or difficulty breathing, you should seek medical attention. You can find the latest information and advice at the NHS website.