Ms. Tram presented without fever or shortness of breath, but had several underlying conditions including chronic hepatitis B, hypertension, and dyslipidemia. To investigate the prolonged cough, she underwent a low-dose chest CT scan to screen for lung parenchymal damage and tumors, along with respiratory function tests and FeNO (a test assessing airway inflammation). All results were within normal limits.

Dr. Nguyen Hoang Anh Duy, from the Department of General Internal Medicine at Tam Anh General Hospital Ho Chi Minh City, ruled out chronic respiratory disease as the cause. An ENT endoscopy revealed exudative rhinitis, pharyngolaryngitis, and signs indicative of gastroesophageal reflux disease (GERD).

Dr. Duy concluded that the persistent cough originated not from the lungs, but from frequent stomach acid reflux irritating the pharynx and larynx, leading to chronic inflammation and a dry cough.

Dr. Duy explains the cause of the cough to Ms. Tram. *Photo: Tam Anh General Hospital*.

According to Dr. Duy, many individuals with reflux do not experience typical heartburn or acid regurgitation symptoms. Instead, they present with persistent cough, hoarseness, an itchy throat, or frequent throat clearing. Consequently, the condition is often overlooked or misdiagnosed as common pharyngitis. Cough suppressants or antibiotics offer only temporary symptom relief if the underlying reflux cause remains untreated.

The patient received treatment to manage reflux, combined with symptom-reducing medication and ongoing monitoring for her underlying conditions. After four days, her cough episodes decreased by 60-70%, and her health significantly improved. She no longer experienced chest pain or fever and was discharged.

Dr. Duy stated that a cough lasting over eight weeks is classified as chronic and should not be dismissed as a symptom of a common cold or pharyngitis. Beyond respiratory conditions such as asthma, tuberculosis, chronic obstructive pulmonary disease (COPD), and lung cancer, gastroesophageal reflux disease is also a common cause. Individuals experiencing a persistent cough for more than eight weeks, especially if accompanied by hoarseness, chest pain, weight loss, or coughing blood, should seek medical evaluation rather than self-medicating with cough remedies.

Nhat Thanh

*Patient's name has been changed