Tracey from Houston sent us this question: “I am 2 1/2 years post op gastric sleeve surgery and have a terrible chronic cough that no one can seem to get to the bottom of, lungs are clear but constant nasal drainage, coughing and at time throwing up but nothing comes up it’s bizarre.”

Dear Tracey,

Cough is a common acid reflux symptom following sleeve gastrectomy. Acid and bile escape the gastric sleeve up into the esophagus and can reach the throat. Throat irritation by acid and bile leads to cough, hoarseness, sore throat and globus. Globus is the sensation of something stuck in the throat that you need to clear all the time. In certain cases, acid and bile get into the lungs and patients develop asthma.

I recommend consultation with a Houston acid reflux specialist at Houston Heartburn and Reflux Center to rule out acid reflux in the setting of sleeve gastrectomy leading to cough. Workup includes upper endoscopy to check for hiatal hernia, esophagitis, bile gastritis and to evaluate gastric sleeve lumen. A narrowed or twisted gastric sleeve lumen favors acid reflux.

In most cases, hiatal hernia repair is the only treatment you need. Hiatal hernias are very common in patients undergoing sleeve gastrectomy. If a hiatal hernia is not repaired at the same time of gastric sleeve surgery acid reflux occurs.