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Gastro-oesophageal reflux and cough
Rayid Abdulqawi1, Lesley A Houghton2, Jaclyn A Smith1
1Respiratory and Allergy Centre, The University of Manchester, University Hospital of South Manchester, Manhester, UK.
The Journal of the Association of Physicians of India
|February 5, 2014
Summary
Gastro-oesophageal reflux is a suspected cause of chronic cough, but its role is complex. Acid suppression therapies often show limited effectiveness, suggesting other factors are involved in the reflux-cough connection.
Area of Science:
- Gastroenterology and Respiratory Medicine
Background:
- Gastro-oesophageal reflux (GER) is frequently implicated as a cause of chronic cough, often alongside conditions like postnasal drip and asthma.
- However, the characteristics of GER in these patients are typically unremarkable, and acid suppression treatments yield minimal therapeutic benefits.
Purpose of the Study:
- To review the complexities and challenges in investigating the relationship between gastro-oesophageal reflux and chronic cough.
- To discuss the strengths and weaknesses of proposed mechanisms linking reflux to cough.
Main Methods:
- Literature review and critical analysis of existing studies on the reflux-cough link.
- Examination of proposed pathophysiological mechanisms.
- Evaluation of diagnostic and therapeutic challenges.
Main Results:
- The direct link between typical gastro-oesophageal reflux and chronic cough remains difficult to establish definitively.
- Standard acid suppression is often ineffective, indicating a need to explore non-acidic reflux or other contributing factors.
- Proposed mechanisms include micro-aspiration and vagal reflex pathways.
Conclusions:
- The diagnosis and management of chronic cough attributed to gastro-oesophageal reflux present significant challenges.
- Further research is needed to elucidate the precise mechanisms and identify effective treatment strategies beyond simple acid suppression.
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