Chronic Cough Due to Gastroesophageal Reflux

Irwin, Richard S.; French, Cynthia L.; Curley, Frederick J.; Zawacki, John K.; Bennett, Frederick M.

doi:10.1378/chest.104.5.1511

Cited by 250 publications

(49 citation statements)

References 12 publications

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“…lower than the 10–31% reported previously [19]. Twenty-four-hour esophageal pH monitoring, the most sensitive and specific test in linking GERD and cough in a ‘cause-effect’ relationship, is generally accepted as the golden standard for the diagnosis of GERD [20].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Cause Distribution between Elderly and Non-Elderly Patients with Chronic Cough

Wei

Lü

et al. 2008

Respiration

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Background: The causes of chronic cough in elderly patients have not been specifically investigated. Therefore, it remains to be determined whether chronic cough differs between elderly and non-elderly patients. Objectives: To investigate the distribution of causes of chronic cough in elderly patients in comparison with etiologies of chronic cough observed in non-elderly patients. Methods: From 2,989 new patients presenting consecutively to the Department of Respiratory Medicine of the Tongji Hospital over a 1.5-year period, 287 patients with chronic cough were enrolled in the study. Patients aged ≥60 years were assigned to the elderly group. The elderly group comprised 104 patients and the non-elderly group the remaining 183 patients. The causes of cough were primarily evaluated according to a modification of Irwin’s anatomic diagnostic protocol which included induced sputum cytology, verified by the specific therapy. Results: Cough-variant asthma (34.6 vs. 41.5%) and upper airway cough syndrome (19.3 vs. 23.5%) were the most common causes of chronic cough both in the elderly and non-elderly groups. The distribution of causes and frequency were significantly different between elderly and non-elderly groups: angiotensin-converting enzyme inhibitor (ACEI)-induced cough (16.3 vs. 1.7%, χ² value = 22.12, p < 0.001) and gastroesophageal reflux disease (GERD; 10.6 vs. 3.7%, χ² value = 5.14, p = 0.02) were more common in the elderly group. Conclusions: A more frequent incidence of ACEI-induced cough and GERD is the distinctive feature in the cause distribution between elderly and non-elderly patients with chronic cough.

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Section: Discussionmentioning

confidence: 99%

Comparison of Cause Distribution between Elderly and Non-Elderly Patients with Chronic Cough

Wei

Lü

et al. 2008

Respiration

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“…In his review Richter [25] concluded that classical reflux symptoms might be present in 40–60% of asthmatics and 43–75% of patients with ear, nose and/or throat complaints. Irwin et al [26] found that 43–75% of patients with GERD-related cough were reflux symptom-free. In our study heartburn and/or acid regurgitation were detected in 54 and 43% of patients with respiratory complications of GERD.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Respiratory Symptoms and Diseases Associated with Gastroesophageal Reflux Disease

et al. 2005

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Aim: Investigation of the prevalence of respiratory symptoms and diseases associated with gastroesophageal reflux disease (GERD). Patients and Methods: 299 subjects with GERD were submitted to upper gastrointestinal endoscopy and 24-hour esophageal pH monitoring and a symptom analysis. Results: Chronic respiratory symptoms or diseases were present in 18% (56/299). Chronic cough was observed in 42/56 patients, while typical reflux symptoms such as heartburn and acid regurgitation were observed in 30/56 and 24/56 cases, respectively. The prevalence of airway diseases was chronic bronchitis 12/56, asthma 10/56, recurrent pneumonia 10/56, chronic sinusitis 7/56 and chronic laryngitis 1/56. In patients with respiratory complications pathologic acid reflux was established in 29/51 cases on the basis of the DeMeester score, while 17/51 had pathologic postprandial, nocturnal or diurnal reflux events. Upper gastrointestinal endoscopy revealed a normal esophageal mucosa in 6/56, Savary-Miller stage I esophagitis in 23/56, stage II in 15/56, stage III in 5/56 and stage IV in 6/56 patients. Conclusions: These investigations have demonstrated an abnormal 24-hour pH score in about half of the patients with GERD-associated respiratory complications, and indicated that short reflux events are characteristic of the reflux activity in one third of this population.

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“…Chronic cough linked to GERD can be the sole presentation of GERD [38]. Micro-aspiration of refluxate has been demonstrated to cause symptoms after acid enters the pulmonary system [39][40][41][42].…”

Section: Chronic Coughmentioning

confidence: 99%

“…Reduced lower oesophageal sphincter pressure and change in oesophageal motility, reduced salivary flow rate, increase in abdominal pressure (obesity, pregnancy) [52] Factors precipitating reflux Diet -onions, fatty foods, chocolate, peppermint, spicy foods and pickles [38]; alcohol -reduces LOS tone, delays gastric emptying and increasing GOR [44] -it is also an irritant of the oesophageal mucosa Posture -bending or lying down increases GOR [38,52] Exercise -heartburn and nausea can occur as a result of strenuous exercise [53,54] Alcohol -reduces the LOS tone [55] diagnostic uncertainty or insufficient therapeutic effect on the symptoms specialist opinion is sought. The most commonly used techniques used to investigate GERD are endoscopy followed by 24-hour ambulatory pH monitoring measuring a drop in oesophageal pH below 4 [57].…”

Section: Mechanisms Involved With Refluxmentioning

confidence: 99%

Intrinsic Causes of Erosion

Moazzez

Bartlett²

2014

Monographs in Oral Science

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Gastric juice entering the mouth causes dental erosion. Common causes for the migration of gastric juice through the lower and upper oesophageal sphincters are reflux disease, laryngopharyngeal reflux, eating disorders, chronic alcoholism and pregnancy. Gastroesophageal reflux is a common condition affecting up to 65% of the Western population at some point in their lifetime. A typical clinical sign of acidic gastric juice entering the mouth is palatal dental erosion. As the condition becomes more chronic it becomes more widespread. There have been relatively few randomised studies investigating the aetiology of acids causing erosion. Of the few that have reported their findings, it appears that gastric acids have the potential to induce moderate-to-severe erosion. This literature review reports the conditions associated with the movement of gastric juice and dental erosion using medical and dental sources.

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Chronic Cough Due to Gastroesophageal Reflux

Cited by 250 publications

References 12 publications

Comparison of Cause Distribution between Elderly and Non-Elderly Patients with Chronic Cough

Comparison of Cause Distribution between Elderly and Non-Elderly Patients with Chronic Cough

Prevalence of Respiratory Symptoms and Diseases Associated with Gastroesophageal Reflux Disease

Intrinsic Causes of Erosion

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