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Hiatus hernia

I have recently been prescribed methotrexate and it has helped, my feet are still very painful but other joints are less so. I have had to stop for 2 weeks as I have developed a dry cough. I have a hiatus hernia (medicated with lansoprazole) and it does seem my reflux is worse. Has anyone else noticed this? It may just be coincidence. The reason I ask is prior to diagnosis I had a cough that wasn't responding to treatment and wonder if the cough I have now is related to that plus methotrexate. I hope I've explained my dilemma. Bit muddle headed lately (metho?)

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I have had a dry cough for over a year, I also have a HH too. This is partly to blame for it. I also take lansoprazol. My doctor explained although I don't get the acid reflux I used to get I apparently still do get reflux. My cough is mostly when I lay down at night. I started mtx in August, was on Azathioprine before this. I had an X-ray in July, a ct scan in November and another X-ray in December, I have a 4mm nodule on my 5th rib and an 8 mm white opacity on my right lower lobe, the latter is possibly caused by reflux, and meds. I got a cold after Christmas and still have a cough, hoping this will clear soon. Go to your GP and get it checked out. Good luck X


Thank you! I had nodules on my lungs too! Caused much dilemma as nodule discovered before diagnosis of RA......

I will get chest checked by GP, nurse at the hosp didn't even listen to my chest.

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My GP wasn't overly concerned, I am awaiting the results of an ultrasound on my liver as possible cysts. I can understand how worried you were before your RA diagnosis. I was too and I have had RA many years, we can't always assume it's RA related and need reassurance. Let me know how you get on. Hugs X


I wouldn't mind betting that if you started every meal (incl breakfast) with a simple bowl of undressed salad or steamed green veg your cough would clear up.



When I started taking MTX just over a year ago. I was told any sign of a dry cough and I was to stop taking MTX immediately and to go to GP and request a chest x-ray as a matter of urgency. The Consultant is usually calm about stuff but in this case he intended to alarm me as this is a serious matter he said.

I have lung involvement with my RA. It is very mild but the MTX doubles the risk of lung damage if your lungs are involved with your RA though the risk still remains below 5%.

After a couple of months and not developing a dry cough my Consultant told me the risk of the MTX causing probs with my lungs is not of a great issue now but I was to continue to be vigilant.

As for acid reflux. I had acid reflux but some months after taking the MTX so the chest consultant told me to double up on my Lansoprazole for a while. It took a good couple of months but it did do the trick and cleared the reflux issue. However my cough with the reflux was not dry I would spit up clear phlegm.

Don't mean to alarm you but get that chest checked by someone who's not a dip stick.


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Thank you. I was rather surprised the rheumatology nurse didn't ask me to go along to X-ray while I was at hosp.

I'll pay my gp a visit this week.

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Hi Fran,

Sorry to hear that you are feeling so ill at the moment,that cough can really get on your nerves can't it. As everyone has said do go and get it checked out with your gp and don't stand for being brushed off about it.

I started with a dry cough 5 year's ago which then started giving me chest pains and breathlessness after a couple of years. Gp said it was probably RA ( I've had for 15 year's ) in my breast bone. This went on until I saw a locum who had experience with RA, sent me for tests and I was diagnosed in September 2015 with pulmonary fibrosis. I had numerous nodules in my lungs and scaring tissue throughout my lungs. Nodules in my upper lobes were around 4mm and lower lobes had numerous 6 to 8 mm nodules. This last 6 month's I've got worse with my chest and breathing, and my last ct scan and lung function tests show considrable deterioration, so I'm having a meeting to discuss oxygen therapy.

I really don't wish to sound all doom and gloom but untill that September I never even knew that RA could affect all your organs and all tissue, and muscle etc and I wish I had known as I would have insisted for tests earlier.

I also have a stomach ulcer,acid refux and hiatus hernia mainly caused by the high dosage of sulfasalizine, these conditions also cause damage to the lungs.

One thing that I would like to mention is because of numerous chest infection and pleurisy this last year I've been on antibiotics and steroids in high doses. My lung consultant wrote to my gp last week to say lung disease caused by rheumatoid unlike other lung diseases doesn't respond to steroids and research being done now is starting to show that steroids can even cause more damage to the lungs. Again worth asking gps or rheumatologist.

Obviously this is my experience and I'm no expert apart from knowing my body, and pulmonary fibrosis ( caused by RA ) is actually very rare, some people who have small nodules don't ever realise there's a problem with their lungs. But, because some people do develop PF then I think we need to know as much as we can to protect ourselves.

Even some of the top rheumatologist s now refer to our illness as rheumatoid disease because that is what it is, a disease that can affect you anywhere not just your joints.

I wish you all the best Fran ,do let me know how you are getting on.

Take care Linda x


Goodness Linda that's really hard for you. RA can be vicious. It's very hard as a patient to know which way to jump. Thank you for taking the time to share. I wish you well too 🍀

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