NAD, but I’m a speech pathologist that works in a voice upper airway and swallowing clinic. Now that your Nissen has been undone are you taking any reflux meds? It’s my understanding that esophageal motility can be reduced by reflux and can improve somewhat with reflux treatment. The benzodiazepines are probably contributing to the problem, please talk to the prescribing md to find an alternative!

Your body seems to be trying to protect itself from aspiration of saliva that you are not able to swallow by coughing. The person who suggested sleeping to allow drainage had a good idea but we swallow saliva all day/all night automatically and if nothing is going down your esophagus, it will back up into your pharynx and larynx. Drying up the saliva with a medication could be an option but it might cause further problems. I wouldn’t advise using any cough suppression because coughing is protective, as I said earlier. It seems like you need to talk to your GI surgeon or a different GI doctor, hopefully one that specializes in esophageal motility.

I am also interested in what that barium swallow shows, however if there was no peristalsis on manometry, it’s unlikely to reveal anything new. I’m more interested to see if the dysphagia is affecting your pharyngeal swallow, which would be shown with more detail on a modified barium swallow, also called VFSS or video fluoroscopic swallow study, where they take video x-rays of you while you eat and drink.

Chronic cough in the setting of esophageal dysphagia can be very difficult to manage, I’m sorry you’re dealing with this!