A causal relationship between cough and gastroesophageal reflux disease (GERD) has been established: A Pro/Con debate

Peter J. Kahrilas, Jaclyn A. Smith, Peter V. Dicpinigaitis

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

Along with upper airway cough syndrome (formerly, postnasal drip syndrome) and eosinophilic airway inflammation (asthma, nonasthmatic eosinophilic bronchitis), gastroesophageal reflux disease (GERD) is generally considered among the most common etiologies of chronic cough. Indeed, cough management guidelines published by numerous respiratory societies worldwide recommend evaluation and treatment of GERD as an integral component of the diagnostic/therapeutic algorithm for the management of chronic cough. However, a significant number of patients with chronic cough presumed due to GERD do not report improvement despite aggressive acid-suppressive therapy. Some of these refractory cases may be due to the recently appreciated entity of nonacid or weakly acidic reflux. Further contributing to the controversy are recent studies that demonstrate that patients with chronic cough do not have excessive reflux events relative to healthy volunteers. Although a temporal relationship between cough and reflux events has been suggested by studies utilizing impedance-pH monitoring of reflux events and objective cough recording, consensus is lacking in terms of whether this temporal relationship proves a causal link between reflux and cough. The fourth American Cough Conference (New York, June 2013) provided an ideal forum for the debate of this issue between two internationally recognized experts in the field of reflux and chronic cough.

Original languageEnglish (US)
Pages (from-to)39-46
Number of pages8
JournalLung
Volume192
Issue number1
DOIs
StatePublished - Feb 1 2014

Keywords

  • Cough
  • Esophagus
  • Gastroesophageal reflux disease
  • Impedance-pH monitoring
  • Proton pump inhibitors
  • Reflux testing
  • pH monitoring

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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