GERD can in rare cases cause fistulas.
Prolonged and severe cases of GERD can cause esophageal ulcers and inflammation and can in turn create a pathway or fistula to occur between your esophagus and other structures which can include your stomach or even your aorta in extreme cases.
A fistula is a type of abnormal connection or tube like passage that connects 2 organs or an organ to the body's surface that occurs between two body body parts like an organ or a blood vessel or other structure in the body.
Fistulas are often the result of surgery or an injury.
Although fistulas can also be caused by infections such as bacteria or fungal infections, chronic inflammation, certain types of cancer such as rectal cancer and anal cancer or even complications from childbirth due to tearing or infection.
A fistula can cause cough, especially if the fistula you have involves your digestive system or respiratory tract, or if the fistula is near your respiratory tract it can cause coughing.
The reason why fistulas can cause a cough is because when the fistula is near the airways and when a fistula connects your esophagus or other digestive organs to your trachea or bronchi such as a bronchobiliary fistula or tracheoesophageal fistula it can cause substances like mucus, bile, stomach acid or even food to leak into your airways.
When these substances leak into your airways it can trigger coughing as your body is trying to clear the irritation of any foreign matter.
With a fistula aspiration is also possible in cases such as a tracheoesophageal fistula where your esophagus and your trachea are connected it can lead to aspiration when you inhale food or other liquids into your lungs and lead to choking, coughing and other respiratory distress.
Inflammation and irritation can also occur with a fistula which can lead to coughing and cough reflex and increased sensitivity.
Fistulas are also prone to infections and infections in your lungs or your airways can also cause your cough.
Common types of fistulas that can cause coughing include.
Tracheoesophageal fistula which is a connection between the esophagus and trachea, often present at birth, can cause coughing, choking, and breathing problems when food or liquid enters the airways.
Bronchobiliary fistula which is a connection between the bronchi and biliary tract (liver and gallbladder) can lead to coughing, as bile and other substances may enter the airways.
Esophago-respiratory fistulae are fistulas which can occur due to various causes including esophageal cancer, can cause chronic cough, dysphagia (difficulty swallowing), and other respiratory symptoms.
Pancreaticothoracic fistula are a type of fistula between the pancreas and chest can cause a cough, as well as other respiratory issues like hemoptysis (coughing up blood) and pneumothorax (collapsed lung).
Choledochoduodenal fistula are a type of fistula between the common bile duct and the duodenum can result in chronic cough due to the reflux of bile into the airways.