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Improved diagnosis of gastro‐oesophageal reflux in patients with unexplained chronic cough
Author(s) -
BLONDEAU K.,
DUPONT L. J.,
MERTENS V.,
TACK J.,
SIFRIM D.
Publication year - 2007
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2007.03255.x
Subject(s) - reflux , medicine , chronic cough , heartburn , proton pump inhibitor , gastroenterology , regurgitation (circulation) , nerd , chest pain , esophageal ph monitoring , gastro , gerd , asthma , disease
Summary Background Symptoms, oesophageal pHmetry and proton pump inhibitor treatment are used for diagnosing gastro‐oesophageal reflux‐related cough . Weakly acidic reflux is now increasingly associated with reflux symptoms such as regurgitation or chest pain. Aim To study the association between weakly acidic reflux and cough in a selected, large group of patients with unexplained chronic cough. Methods A total of 100 patients with chronic cough (77 ‘off’ and 23 ‘on’ a proton pump inhibitor) were studied using impedance‐pHmetry for reflux detection and manometry for objective cough monitoring. Symptom Association Probability (SAP) Analysis characterized the reflux–cough association. Results Acid reflux could be a potential mechanism for cough in 45 patients (with either heartburn, high acid exposure or +SAP for acid reflux). Weakly acidic reflux could be a potential mechanism for cough in 24 patients (with either increased oesophageal volume exposure, increased number of weakly acidic reflux or +SAP for weakly acidic reflux). Reflux could not be identified as a potential mechanism for cough in 31 patients. Conclusion A positive association between cough and weakly acidic reflux was found in a significant subgroup of patients with unexplained chronic cough. Impedance‐pH‐manometry identified patients in whom cough can be related to reflux that would have been disregarded using the standard diagnostic criteria for acid reflux.