Nonacid Reflux in Patients With Chronic Cough on Acid-Suppressive Therapy

Tutuian, Radu; Mainie, Inder; Agrawal, Amit; Adams, David B.; Castell, Donald O.

doi:10.1378/chest.130.2.386

Cited by 175 publications

(138 citation statements)

References 17 publications

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“…Tutuian et al demonstrated that impedance testing discriminated the subgroup of 13 patients (26% of the cohort) who had persistent cough following reflux events despite PPI therapy. 67 Another study found that patients with reflux symptoms and normal pH tests were more likely to have non-acid reflux episodes extending into the proximal oesophagus than were control patients. 63 There are no studies describing impedance measures in patients with ALD.…”

Section: Diagnostic Testing: the Current Limiting Factormentioning

confidence: 99%

Gastro-oesophageal reflux and aspiration in patients with advanced lung disease

Sweet

Patti

Hoopes

et al. 2009

Thorax

125

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Section: Diagnostic Testing: the Current Limiting Factormentioning

confidence: 99%

Gastro-oesophageal reflux and aspiration in patients with advanced lung disease

Sweet

Patti

Hoopes

et al. 2009

Thorax

125

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“…The term "weak acid reflux", which was noticed after understanding the nature (air-water), direction (swallowingreflux), and pH (acid, weak acid, or weak alkaline=non-acid reflux) of the content in the esophagus through MII-pH monitoring, was started to be used in GERD (38-40). MII-pH monitoring is the most sensitive tool to evaluate GERD in patients with both typical and atypical reflux symptoms (41)(42)(43)(44)(45)(46). The impact of the method on symptom association has clearly been demonstrated in several studies (47)(48)(49).…”

Section: Combined Ph Monitoring and Multichannel Impedancementioning

confidence: 99%

Indications of 24-h esophageal pH monitoring, capsule pH monitoring, combined pH monitoring with multichannel impedance, esophageal manometry, radiology and scintigraphy in gastroesophageal reflux disease?

Vardar

Keskın

2017

Turk J Gastroenterol

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“…The rationale, being the persistence of non-acid reflux in spite of PPI's. So far, uncontrolled studies are encouraging [41][42][43], and there is a need for new outcome controlled studies with objective cough measurements before and after surgery to consolidate the recommendation for antireflux surgery in patients with chronic cough not responding to PPI's. …”

Section: Treatment Of Reflux Related Coughmentioning

confidence: 99%

Cough and gastroesophageal reflux: From the gastroenterologist end

Pauwels¹,

Blondeau²,

Dupont³

et al. 2009

Pulmonary Pharmacology & Therapeutics

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Gastroesophageal reflux (GER) is one of the three most common causes of chronic unexplained cough. Diagnosing GER related cough is challenging since many patients do not have esophagitis or an increased esophageal acid exposure during 24h esophageal pH-metry. A significant time association between acid reflux and cough can be demonstrated in a subgroup of patients, even if the total esophageal acid exposure is normal. Establishing an exact time relationship between reflux and cough requires objective measurements of both cough and reflux episodes. A variety of techniques for cough assessment are available, including sound recordings and continuous measurement of gastroesophageal pressures. The Symptom Association Probability (SAP) has been suggested as the most reliable algorithm to establish the non-chance association between GER and cough. Although the relationship between acid reflux and cough is generally accepted, the response rate of patients with chronic unexplained cough to proton pump inhibitor treatment (PPI) is poorer compared to that in patients with typical GERD symptoms. Combined impedance-pH recordings, a new technique for the measurement of all types of reflux, have recently shown that not only acid but also weakly acidic GER may be associated with cough. Moreover, measurements in patients "on" PPI therapy demonstrated that weakly acidic reflux may persist during PPI treatment and may be associated with cough.

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Nonacid Reflux in Patients With Chronic Cough on Acid-Suppressive Therapy

Cited by 175 publications

References 17 publications

Gastro-oesophageal reflux and aspiration in patients with advanced lung disease

Gastro-oesophageal reflux and aspiration in patients with advanced lung disease

Indications of 24-h esophageal pH monitoring, capsule pH monitoring, combined pH monitoring with multichannel impedance, esophageal manometry, radiology and scintigraphy in gastroesophageal reflux disease?

Cough and gastroesophageal reflux: From the gastroenterologist end

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