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Кашель при изжоге: взаимосвязь и лечение. | Изжоги.нет - информационный портал | Проблемы

Изжога и кашель: где связь?


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Хронический кашель длится дольше 8 недель, и хотя он не является типичным симптомом гастроэзофагеальной рефлюксной болезни (что такое ГЭРБ – читайте здесь), в 25% случаев ГЭРБ всё-таки связана с кашлем. Объяснения этому может быть два.

Первое: кашель возникает как рефлекторное действие повышения уровня желудочной кислоты в пищеводе. Второе: во время рефлюкса небольшое количество кислоты попадает на голосовые связки или в горло, и кашель развивается как защитный механизм. Такой тип рефлюкса называют фаринголарингеальным (ФЛР), немым или атипичным.

Симптомы фаринголарингеального рефлюкса

Соляная кислота при попадании на голосовые связки или в горло может вызвать воспаление и привести к кашлю и охриплости. При этом для того чтобы вызвать раздражение слизистой оболочки, достаточно самого маленького количества желудочного сока. Интересно, что в 75% случаев, когда кашель связан с кислотным рефлюксом, человек не ощущает никаких неприятных желудочно-кишечных симптомов.

Устранение кашля

Лечить кашель, возникший вследствие гастроэзофагеальной рефлюксной болезни, бесполезно. Нужно работать с первопричиной, то есть с ГЭРБ.

Лечение ГЭРБ, прежде всего, предполагает изменения в образе жизни. Ограничение потребления алкоголя, курения, кофеина и жирной пищи обязательно. Чтобы уменьшить давление на живот, следует носить свободную одежду, не переедать, не лежать сразу после или во время приема пищи. Если имеется избыточный вес, пациенту необходимо его сбросить. В этом поможет лечебная диета №1.

Что касается медикаментозной терапии, то наибольшую эффективность показало совместное применение прокинетиков и ингибиторов протонной помпы (ИПП). Если симптомы уменьшаются при применении ИПП, это говорит о связи кашля с кислотным рефлюксом.

Другие причины хронического кашля

Конечно, существует множество других причин развития хронического кашля, не связанных с заболеваниями желудочно-кишечного тракта. Наиболее распространенные это:

  • инфекции дыхательных путей;
  • хронический бронхит;
  • астма;
  • курение;
  • лекарственные препараты (капли для носа, ингибиторы АПФ).

Если кашель сохраняется в течение 3-х недель без улучшения или сопровождается болью в груди, это серьезный повод обратиться к врачу.

 

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    Debug: (0,091013) - (usage: 9986752) - (peak: 10085928)
    (mysql): SELECT * FROM izjoga_content_props WHERE content_id = '43'
    
    Debug: (0,091193) - (usage: 9990872) - (peak: 10088656)
    (mysql): SELECT * FROM izjoga_content_props WHERE content_id = '44'
    
    Debug: (0,091343) - (usage: 9994976) - (peak: 10091352)
    (mysql): SELECT * FROM izjoga_content_props WHERE content_id = '45'
    
    Debug: (0,09154) - (usage: 9999080) - (peak: 10094064)
    (mysql): SELECT * FROM izjoga_content_props WHERE content_id = '46'
    
    Debug: (0,091777) - (usage: 10006032) - (peak: 10096728)
    (mysql): SELECT * FROM izjoga_content WHERE content_id IN (23) ORDER BY hierarchy
    
    Debug: (0,092609) - (usage: 10109760) - (peak: 10180832)
    (mysql): SELECT * from izjoga_module_templates WHERE module_name = 'MenuManager' and template_name = 'new' LIMIT  1
    
    Debug: (0,09277) - (usage: 10114728) - (peak: 10197232)
    (mysql): SELECT module_name,template_name,modified_date 
                                FROM izjoga_module_templates
    
    Debug display of 'End of Menu Manager Display':(0,098409) - (usage: 10158072) - (peak: 10434160)
    Debug: (0,098519) - (usage: 10082680) - (peak: 10434160)
    start global_content_get_template
    Debug: (0,099034) - (usage: 10185064) - (peak: 10434160)
    Loading /var/www/vhosts/izjogi.net/httpdocs/lib/classes/class.globalcontentoperations.inc.php = 101080 bytes for an approximate total of 4777496
    Debug: (0,099276) - (usage: 10191056) - (peak: 10434160)
    (mysql): SELECT htmlblob_id, htmlblob_name, html, owner, use_wysiwyg, description, modified_date FROM izjoga_htmlblobs WHERE htmlblob_name = 'Search' LIMIT  1
    
    Debug: (0,099359) - (usage: 10193152) - (peak: 10434160)
    end global_content_get_template
    Debug: (0,099376) - (usage: 10193536) - (peak: 10434160)
    start global_content_get_timestamp
    Debug: (0,09939) - (usage: 10193960) - (peak: 10434160)
    end global_content_get_timestamp
    Debug: (0,100617) - (usage: 10227944) - (peak: 10470920)
    Loading /var/www/vhosts/izjogi.net/httpdocs/modules/CGExtensions/lib/class.cge_tmpdata.php = 10160 bytes for an approximate total of 4787656
    Debug: (0,101355) - (usage: 10333424) - (peak: 10470920)
    Loading /var/www/vhosts/izjogi.net/httpdocs/modules/CGExtensions/lib/class.cge_utils.php = 74256 bytes for an approximate total of 4861912
    Debug: (0,101381) - (usage: 10332216) - (peak: 10470920)
    Nothing is known about FrontEndUsers... cant load it
    Debug: (0,102002) - (usage: 10440824) - (peak: 10548504)
    Loading /var/www/vhosts/izjogi.net/httpdocs/modules/CGBlog/lib/class.cgblog_article.php = 106544 bytes for an approximate total of 4968456
    Debug: (0,102172) - (usage: 10445896) - (peak: 10553088)
    (mysql): SELECT mn.* FROM izjoga_module_cgblog mn WHERE status = 'published' AND  cgblog_id = 126 LIMIT  1
    
    Debug: (0,102389) - (usage: 10457512) - (peak: 10558072)
    (mysql): SELECT A.value,B.id,B.name,B.type 
                  FROM izjoga_module_cgblog_fieldvals A, izjoga_module_cgblog_fielddefs B 
                  WHERE A.fielddef_id = B.id AND A.cgblog_id = '126' ORDER BY B.item_order
    
    Debug: (0,102796) - (usage: 10478384) - (peak: 10571288)
    Loading /var/www/vhosts/izjogi.net/httpdocs/modules/CGBlog/lib/class.cgblog_field.php = 19384 bytes for an approximate total of 4987840
    Debug: (0,102966) - (usage: 10481424) - (peak: 10583152)
    (mysql): SELECT A.category_id,B.name 
                      FROM izjoga_module_cgblog_blog_categories A
                      LEFT JOIN izjoga_module_cgblog_categories B
                        ON A.category_id = B.id
                     WHERE A.blog_id = '126'
    
    Debug: (0,103116) - (usage: 10476216) - (peak: 10586760)
    (mysql): UPDATE izjoga_module_cgblog SET views = views + 1 WHERE cgblog_id = 126
    
    Debug: (0,103419) - (usage: 10502856) - (peak: 10618832)
    (mysql): SELECT * from izjoga_module_templates WHERE module_name = 'CGBlog' and template_name = 'detailSample' LIMIT  1
    
    Debug: (0,112236) - (usage: 10922968) - (peak: 11300248)
    Nothing is known about FrontEndUsers... cant load it
    Debug: (0,112885) - (usage: 10930088) - (peak: 11300248)
    (mysql): SELECT count(DISTINCT mn.cgblog_id) as count
                 FROM izjoga_module_cgblog mn WHERE status = 'published' AND ( IFNULL(start_time, '1970-01-01 03:00:01')  < '2018-12-18 18:59:05') AND (( IFNULL(end_time, '1970-01-01 03:00:01')  = '1970-01-01 03:00:01') OR (end_time > '2018-12-18 18:59:05')) LIMIT  1
    
    Debug: (0,115052) - (usage: 10938720) - (peak: 11300248)
    (mysql): SELECT DISTINCT mn.*
                 FROM izjoga_module_cgblog mn WHERE status = 'published' AND ( IFNULL(start_time, '1970-01-01 03:00:01')  < '2018-12-18 18:59:05') AND (( IFNULL(end_time, '1970-01-01 03:00:01')  = '1970-01-01 03:00:01') OR (end_time > '2018-12-18 18:59:05'))  ORDER BY RAND() desc LIMIT 0, 2
    
    Debug: (0,115279) - (usage: 10950192) - (peak: 11300248)
    (mysql): SELECT A.category_id,B.name 
                      FROM izjoga_module_cgblog_blog_categories A
                      LEFT JOIN izjoga_module_cgblog_categories B
                        ON A.category_id = B.id
                     WHERE A.blog_id = '111'
    
    Debug: (0,115463) - (usage: 10952824) - (peak: 11300248)
    (mysql): SELECT A.value,B.id,B.name,B.type FROM izjoga_module_cgblog_fieldvals A, izjoga_module_cgblog_fielddefs B WHERE A.fielddef_id = B.id AND B.public = 1 AND A.cgblog_id = '111' ORDER BY B.item_order
    
    Debug: (0,116274) - (usage: 10961680) - (peak: 11300248)
    (mysql): SELECT A.category_id,B.name 
                      FROM izjoga_module_cgblog_blog_categories A
                      LEFT JOIN izjoga_module_cgblog_categories B
                        ON A.category_id = B.id
                     WHERE A.blog_id = '38'
    
    Debug: (0,116402) - (usage: 10963344) - (peak: 11300248)
    (mysql): SELECT A.value,B.id,B.name,B.type FROM izjoga_module_cgblog_fieldvals A, izjoga_module_cgblog_fielddefs B WHERE A.fielddef_id = B.id AND B.public = 1 AND A.cgblog_id = '38' ORDER BY B.item_order
    
    Debug: (0,117304) - (usage: 11119200) - (peak: 11371448)
    (mysql): SELECT * from izjoga_module_templates WHERE module_name = 'CGBlog' and template_name = 'summarysameArticles' LIMIT  1
    
    Debug: (0,121635) - (usage: 10979256) - (peak: 11553352)
    Nothing is known about FrontEndUsers... cant load it
    Debug: (0,121938) - (usage: 10988296) - (peak: 11553352)
    (mysql): SELECT id FROM izjoga_module_cgblog_categories WHERE name IN ('news')
    
    Debug: (0,122489) - (usage: 11050840) - (peak: 11553352)
    Loading /var/www/vhosts/izjogi.net/httpdocs/modules/CGExtensions/lib/class.cge_array.php = 60488 bytes for an approximate total of 5048328
    Debug: (0,122829) - (usage: 11055240) - (peak: 11553352)
    (mysql): SELECT count(DISTINCT mn.cgblog_id) as count
                 FROM izjoga_module_cgblog mn LEFT OUTER JOIN izjoga_module_cgblog_blog_categories bc ON mn.cgblog_id = bc.blog_id WHERE status = 'published' AND ( IFNULL(start_time, '1970-01-01 03:00:01')  < '2018-12-18 18:59:05') AND bc.category_id IN (4) AND (( IFNULL(end_time, '1970-01-01 03:00:01')  = '1970-01-01 03:00:01') OR (end_time > '2018-12-18 18:59:05')) LIMIT  1
    
    Debug: (0,124311) - (usage: 11060592) - (peak: 11553352)
    (mysql): SELECT DISTINCT mn.*
                 FROM izjoga_module_cgblog mn LEFT OUTER JOIN izjoga_module_cgblog_blog_categories bc ON mn.cgblog_id = bc.blog_id WHERE status = 'published' AND ( IFNULL(start_time, '1970-01-01 03:00:01')  < '2018-12-18 18:59:05') AND bc.category_id IN (4) AND (( IFNULL(end_time, '1970-01-01 03:00:01')  = '1970-01-01 03:00:01') OR (end_time > '2018-12-18 18:59:05')) ORDER BY mn.cgblog_date desc LIMIT 0, 1
    
    Debug: (0,124448) - (usage: 11068920) - (peak: 11553352)
    (mysql): SELECT A.category_id,B.name 
                      FROM izjoga_module_cgblog_blog_categories A
                      LEFT JOIN izjoga_module_cgblog_categories B
                        ON A.category_id = B.id
                     WHERE A.blog_id = '166'
    
    Debug: (0,124722) - (usage: 11070304) - (peak: 11553352)
    (mysql): SELECT A.value,B.id,B.name,B.type FROM izjoga_module_cgblog_fieldvals A, izjoga_module_cgblog_fielddefs B WHERE A.fielddef_id = B.id AND B.public = 1 AND A.cgblog_id = '166' ORDER BY B.item_order
    
    Debug: (0,125654) - (usage: 11217120) - (peak: 11553352)
    (mysql): SELECT * from izjoga_module_templates WHERE module_name = 'CGBlog' and template_name = 'summaryrightNews' LIMIT  1
    
    Debug: (0,126911) - (usage: 11496184) - (peak: 11704176)
    Loading /var/www/vhosts/izjogi.net/httpdocs/modules/CGExtensions/lib/class.cge_smarty_plugins.php = 182200 bytes for an approximate total of 5230528
    Debug: (0,129162) - (usage: 11196192) - (peak: 11765600)
    (mysql): SELECT count(mq.id) as num
                FROM izjoga_module_questions_questions mq
                LEFT OUTER JOIN izjoga_module_questions_categories mqc
                  ON mqc.id = mq.category_id WHERE mq.answered_date IS NOT NULL AND mq.approved_date IS NOT NULL LIMIT  1
    
    Debug: (0,129875) - (usage: 11203976) - (peak: 11765600)
    (mysql): SELECT mq.*, mqc.name, mqc.long_name
                FROM izjoga_module_questions_questions mq
                LEFT OUTER JOIN izjoga_module_questions_categories mqc
                  ON mqc.id = mq.category_id WHERE mq.answered_date IS NOT NULL AND mq.approved_date IS NOT NULL ORDER BY 8 ASC LIMIT 0,1
    
    Debug: (0,13032) - (usage: 11236672) - (peak: 11765600)
    (mysql): SELECT * from izjoga_module_templates WHERE module_name = 'Questions' and template_name = 'summaryqaRight' LIMIT  1
    
    Debug: (0,137897) - (usage: 11013440) - (peak: 11765600)
    calling module CGExtensions from event ContentPostRender
    Debug: (0,138314) - (usage: 11027352) - (peak: 11765600)
    Loading /var/www/vhosts/izjogi.net/httpdocs/modules/CGExtensions/lib/class.cge_headers.php = 6736 bytes for an approximate total of 5237264
    Debug: (0,138337) - (usage: 11021696) - (peak: 11765600)
    calling module TinyMCE from event ContentPostRender