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[Chronic cough caused by gastroesophageal reflux]
H Matsumoto1, A Niimi, S Satou
1Department of Respiratory Medicine, Kyoto University.
Summary
Gastroesophageal reflux (GER) can cause chronic cough, even without typical symptoms. Prompt diagnosis and treatment with proton-pump inhibitors can effectively alleviate persistent cough.
Area of Science:
- Gastroenterology
- Pulmonology
- Internal Medicine
Background:
- Chronic cough is a common condition with various potential causes.
- Gastroesophageal reflux (GER) is an underrecognized cause of chronic cough.
- Asthma is a frequent misdiagnosis for chronic cough unresponsive to standard treatments.
Observation:
- A 29-year-old woman presented with a 3-year history of chronic cough.
- She had received extensive asthma treatment without relief.
- The patient reported belching but lacked other typical GER symptoms.
Findings:
- Esophageal pH monitoring revealed significantly elevated acid reflux.
- Esophagoscopy did not show evidence of reflux esophagitis.
- Treatment with a proton-pump inhibitor led to marked improvement in cough.
Implications:
- This case highlights GER as a crucial differential diagnosis for chronic cough.
- GER-induced chronic cough may be more prevalent than previously thought, especially in Japan.
- Accurate diagnosis requires considering GER even in the absence of classic symptoms.