Excluding gastroesophageal reflux disease as the cause of chronic cough

Gastroesophageal reflux disease (GERD) is recognized to be present in 10-20% of cases of chronic cough. Proving that it is the cause of the cough is more difficult. This problem is illustrated by way of a case report demonstrating that GERD can still be the cause, even when the patient is unresponsive to conventional use of proton pump inhibitors. In the commentary following the case history, we review the medical literature to confirm that GERD and cough may each precipitate the other. The role of esophageal pH monitoring in difficult cases of chronic cough is explored; we emphasize the use of pH monitoring while the patient is on therapy to prove or disprove the link.