This article was reviewed by Senior Director of Community Engagement and COPD360social Community Manager, Bill Clark, as well as certified staff Respiratory Therapists on January 30, 2020.

Dear COPD Coach,
I have just been diagnosed with COPD. I have suffered with GERD for 25 years and had Nissen wrap surgery (surgery for GERD when other treatments fail) 20 years ago. Surgery helped for awhile, but I still struggled with GERD while experiencing new COPD coughing symptoms with difficulty in breathing. I instinctively lied down on the floor with my head elevated. It seemed to slow the coughing and the sense of mucus dripping in my chest. Is there any validity to this or I’m just hoping?

Thank you,

Dear COPD,
COPD and GERD (Gastro-Esophageal Reflux Disorder) often occur together. Research shows that people with COPD are at far greater risk of developing GERD, and almost half of those with severe COPD also have GERD.

GERD is a digestive disorder in which the valve that keeps stomach contents inside the stomach allows stomach acids to get up into the esophagus. The disease can easily complicate your COPD symptoms. These acids are very irritating to the linings of your lungs. It is thought that GERD develops in people with COPD because they have trapped air in their chest cavities, which may then increase pressure on the abdomen, which leads to gastric reflux. It is also thought that some of the medications used to treat COPD may impair the lower esophageal sphincter which is the valve that keeps acid and food in the stomach.

According to Dr. David Mannino, one sign that the acid reflux of GERD could be affecting your lungs is if you wake up in the middle of the night gagging, especially with a sour taste in your mouth. Heartburn, coughing more frequently, coughing up mucus, and having even more trouble catching your breath all indicate that GERD is likely making your COPD symptoms worse.

While there is no cure for GERD, there are steps you can take to lessen the symptoms which include avoiding spicy foods, alcohol, caffeine, and chocolate. Do not eat right before you go to bed, and keeping the head of your bed slightly elevated. Discuss with your doctor if there are any medications that can also help.

If you are instinctively lying down and keeping your head elevated, you are definitely improving the GERD symptoms, which will also improve your breathing. GERD mostly occurs at night while sleeping, so consider elevating your bed by putting 2X4s under the legs that support the head end of your bed. You can also purchase a inclined pillow (wedge) that will raise the upper part of your body.

The important thing to remember is that there are a number of co-morbidities related to COPD, and GERD is one of them. If your symptoms for GERD get worse, consult with your doctor because it could, in turn, affect your COPD.

Good Luck!
–The COPD Coach

Coaches Corner is aimed at providing information for individuals with COPD to take to your doctor, and is not in any way intended to be medical advice. If you would like to submit a question to the Coaches Corner email us at We would love to hear your questions and comments. You can address your emails to The COPD Coach.


You need to login to comment.
  • Excellent article, COPD Coach!!

    I've dealt with GERD for many years now - my gastroenterologist says I have erosive esophagitis (diagnosed via endoscopy) - and I've taken various meds for it over the years. What works for me, besides raising my head, is a proton-pump inhibitor (currently Prevacid) plus taking Gaviscon (OTC) right before I lie down.

    I no longer wake up in the night with horrible heartburn.

  • I was just diagnosed with it. I had already adjusted my bed with a wedge so it was just making a few changes in diet.
    I am feeling better now, but know it could get to the point of meds. Right now, I'm sleeping well.
    Thank you Karen about the meds. I was on prevacid when I had problems with my esophagus so that wold probably be one! I will check on Gaviscon so I would be ready if needed.

  • Thanks so much. I've not been diagnosed with GERD (had endoscopy last summer), but had periods of really bad acid reflux, but is OK now. They put me on PPI (Nexium) but now my Dr says to stop taking it because of recent news about harmful effects of PPI. So, I've been off of it for about 3 months and doing fine, no problems. Have not taken any non-PPi alternatives, such as Zantac, which was now recommended, but doing fine. I find that if I watch what and when I eat, I'm ok. Yes, that feeling of pressure in the upper abdomen is so aggravating when I lie down.
  • I have COPD. Is having a sore throat constanstantly for a year along with the hartburn and throwing up once a week symptoms of GERD? When is the time to see specialaists for COPD/gastroenterologist?

    • Hello Birdlegs, and welcome to COPD 360social!

      If you are on a management plan prescribed by your family doctor and are still having symptoms that cause pain and / or vomiting, call that doctor and tell him or her about these symptoms. If she says that she is doing all that can be done and you still continue to have these symptoms, talk with your family doctor about referring you to a specialist.

      GERD is a common co-morbidity (another health problem) in people with COPD, so both a pulmonologist and a gastroenterologist should be familiar with this.

      With that said, do keep in mind that inhaled breathing medications can sometimes cause a sore throat, most likely if you are not using a spacer. Your inhaled breathing medications do their work when they go down into your lungs as deep as possible. If these medications are not making it down there, but stopping on your tongue or in your throat, they are not helping your breathing and they may be causing irritation or even a yeast infection in your mouth (always rinse and spit after taking an inhaled corticosteroid inhaler!).

      Birdlegs, I hope this helps. You shouldn't have to endure these ongoing symptoms. Keep asking questions and keep working with your doctors to find solutions that will put you on the road to a good management plan and help you get on with your best quality of life possible.
    • Hi birdlegs-
      While we can't diagnose on this site, I can tell you that if my patients described symptoms like yours, I would encourage them to make an appointment with their doctor. Constant sore throat and heartburn could certainly be from GERD, but only your doctor would know for sure since they know your full medical history. As for when do you need to see specialist: You can do that at any time. Most primary care providers are happy to refer their patients to a pulmonologist or other specialist to help the patient receive the best care for their particular situation. Often times, pulmonologists refine or tweak the therapy plan for a patient that was originally given to them by their PCP. When you start to have changes in your symptoms or symptoms that overlap, for instance, digestive system to respiratory then I would definitely recommend working with a team of doctors so that you have the best treatments available to you.
      Hope that helps!
  • It is always a good rule of thumb that if your symptoms persist to always circle back with your healthcare team and share that. They are the clinical experts and know your condition and medical care the best. Some symptoms can not be managed easily and they need to know when they are not.
    Sometimes you need to not just try pillows, but elevate the bed itself with some short blocks of wood, there is a difference.
  • I did not know about GERD. I have been burping more than usual and it is after I eat chocolate.. I only have one cup of coffee in the morning I hope I don't have to give that up but it's a chocolate ice cream bar that I've been eating because of the Heat. Its a very deep burp. I will talk to my doctor about this. Thank you all?so much for bringing my attention to this. Choclate ice cream bars . I will stop when it gets cooler. Again Thank you
  • I was diagnosed with COPD with emphysema 9 years ago. My Fev1 is 38% now. I use Spiriva and Breo Ellipta inhalers and may switch to Symbicort. ProAir as rescue inhaler.

    About 7 years ago I visited an ENT for a sinus problem. At that time he tested me for GERD and advised me how to treat it. I did put lifts under the legs of my bed but I felt like I was sleeping on a hill. Also, when raising the bed to add the lifts i fractured a vertebrae. So I took them off. I sleep on 2 pillows instead.

    I have been having voice problems on and off for about a year now. My PCP prescribed prednisone and a Z-pak for laryngitis. My pulmo doctor did not believe I had thrush since he could not see any spots in my mouth or throat. Only my cardio doctor showed concern. When I could barely speak I went to see an ENT who checked my larynx and prescribed Nystatin twice. He also prescribed Prilosec for acid reflux. Unfortunately, the Prilosec caused severe diarrhea. He said because it was too strong. The Candida on the larynx has cleared up and I was advised to see my gastro doctor now for my voice and GERD. What is so odd is spicy foods do not give me heartburn nor indigestion. About a year ago, I did wake up at 2 a.m. with what I thought was a heart attack. Called 911 and was transported. After all the tests the nurse gave me a "cocktail" that soothed the chest pain. My PCP told me heartburn usually occurs 3-4 hours after eating. For me, I think eating a heavy meal does me more harm than spicy food and coffee.

    Two years ago i had the esophageal procedure and I was fine.

    Has anyone had a problem with their voice due to GERD? I also read it may make post-nasal drip worse. I use Ponaris at night for dry nasal passages and in the morning Atrovent for runny nose. I am a mess.

    Please advise.
    • I have had problems with my voice due to steroid inhalers. They relax my vocal cords, make my voice "hoarse and husky" and make it difficult to carry a tune.

      I have also had frequent thrush (candida) infections in my throat. I was told that was also due to the steroid inhalers. It is much easier for me to rinse my mouth but I do not always get all of my throat completely rinsed no matter how hard I try. I am prescribed Nystatin when it occurs.
    • I had to look twice to see if this was something I'd written and forgotten about, Terry. My main concern when i first visited the Doc about 6 yrs ago, was the change in tonal qualities of my voice.

      i am 6'4" and used to have a loud booming voice but that gradually subsided to a husky whisper at times and even at best was not able to deliver the depth & tone I was used to but Doc (Not having anything to compare my 'new' self with, was unimpressed. On my insistence sent me for an 'up the nose, down the throat with camera', examination and all the specialist could see was slight reddening.
      In other-words, no signs whatever.

      I then had a bout of Flu with breathlessness and coughing and the Doc suspected I had Emphysema and sent me for an Xray(?)

      Nothing showed and i was now losing patience as they seemed to be ignoring what (I then thought) was my main problem
      I'd had enough so time for a change of Doctor.

      All the new Doc could say was Stop Smoking and problem will get better. Ok Fed up with the moaning, I stopped. Waited 6 Mths and STILL no improvement. Doc was no further help so I changed Docs YET AGAIN.

      New Doc looked at my records and asked me a few questions and then sent me off for a Spirometry test and when i returned with the results he (Correctly ) diagnosed COPD!

      Been on meds ever since, still not smoking (And never will again) and guess what?

      They have STILL not cured my voice.

      Hope you fair better but if not, keep smiling!

  • I know I have it and after a meal I take a natural medication from the health good's herbal calledTriphala by Planetary herbal..also can by on Amazon..which is great because they deliver..It works for me..and I sleep with 2 high pillows..good to read I'm not the only one..I must have one cup of coffee a day..
  • I had COPD, before I TX'd. After transplant I was RX'd generic Prilosec and I also sleepmon a 11" wedge. My broncs have showed no sign of erosion at all. I am a firmly believe that sleeping on the wedge has helped me.
  • I not only have GERD, I also have Barretts esophagus due to burning over the years, Silent Gerd seemed to cause it, my Doctor said it can also start from birth, Anyway Pillow wedges are a life saver and can help with a few nighttime problems most 😊almart's sell them in there bedding section. They're wonderful!
    • Indeed they are.bought one at Penny's on great..Been putting it off buying one but happy I finally did..