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Gastroesophageal reflux and chronic cough
1Academic Department of Medicine, Respiratory Medicine, University of Hull, Castle Hill Hospital, Cottingham, UK.
Minerva Gastroenterologica E Dietologica
|February 25, 2005
Summary
Gastroesophageal reflux disease often causes chronic cough, even without typical heartburn symptoms. Diagnosis requires looking for subtle signs, and treatment trials may need two months for improvement.
Area of Science:
- Gastroenterology
- Pulmonology
- Otolaryngology
Background:
- Gastroesophageal reflux (GOR) disease is a leading cause of chronic cough.
- Traditional GOR symptoms like heartburn are frequently absent in patients with cough.
- Subtle indicators linking cough to esophageal dysfunction are crucial for diagnosis.
Purpose of the Study:
- To highlight diagnostic challenges in GOR-related chronic cough.
- To identify subtle clinical indicators of GOR-induced cough.
- To review diagnostic and therapeutic strategies for GOR-related chronic cough.
Main Methods:
- Clinical observation and analysis of subtle GOR symptoms.
- Review of diagnostic investigations including esophageal manometry and 24-hour pH monitoring.
- Evaluation of empirical treatment trials and pharmacological/surgical interventions.
Main Results:
- Cough associated with eating, phonation, or occurring nocturnally without waking suggests GOR.
- Non-acid reflux can trigger cough, potentially underdiagnosed by pH monitoring.
- Empirical treatment requires at least two months due to cough reflex plasticity.
Conclusions:
- Diagnosing GOR-related chronic cough necessitates attention to non-traditional symptoms.
- Comprehensive diagnostic approaches and extended empirical treatment trials are vital.
- Pharmacological and surgical options offer effective management for select individuals.
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