Open Access
CLINICAL—ALIMENTARY TRACT Acoustic Cough—Reflux Associations in Chronic Cough: Potential Triggers and Mechanisms
Jaclyn A. Smith,Samantha Decalmer,Angela Kelsall,Jones Hp,Simon Galloway,Ashley Woodcock,Lesley A. Houghton +6 more
Reads0
Chats0
TLDR
Cough temporally associates with reflux irrespective of proposed diagnoses, may be self-perpetuating in some patients, and is likely to be driven by central processes.Abstract:
to play a role in chronic cough and might explain the temporal association between cough and gastroesophageal reflux (GOR) in patients in whom non-GOR causes have been excluded. Using our novel simultaneous acoustic cough recording and impedance/pH monitoring technique, we aimed to explore this further by assessing such temporal associations and their relationship to the acidity, duration, and proximal extent of reflux and the presence of erosive disease and cough reflex sensitivity in unselected patients (ie, including non-GOR causes) with chronic cough. METHODS: Twenty-four hour ambulatory acoustic cough monitoring with simultaneous impedance/pH recording was carried out in 71 unselected patients with chronic cough, aged 51‐64 years (47 female). In addition, all patients underwent cough reflex sensitivity testing to citric acid, and 66 patients underwent gastroscopy. Temporal associations between cough and reflux were expressed using the symptom association probability. RESULTS: Seventy percent of patients exhibited temporal associations, with 48% having a positive symptom association probability (SAPR-C) for cough preceded by reflux (mainly distal), 56% a positive symptom association probability (SAP C-R (2 min)) for reflux preceded by cough, and 32% both. Moreover, SAPR-C positive patients had a more sensitive cough reflex (P .03) but similar esophageal reflux exposure and erosive disease, together with similar prevalence of extraesophageal causes of cough compared with SAPR-C negative patients. Reflux immediately following cough was rare. CONCLUSIONS: Cough temporally associates with reflux irrespective of proposed diagnoses, may be self-perpetuating in some patients, and is likely to be driven by central processes.read more
Citations
More filters
Journal ArticleDOI
Guidelines for the Diagnosis and Management of Gastroesophageal Reflux Disease
TL;DR: The following guideline will provide an overview of GERD and its presentation, and recommendations for the approach to diagnosis and management of this common and important disease.
Journal ArticleDOI
Transient receptor potential vanilloid 1 (TRPV1) antagonism in patients with refractory chronic cough: a double-blind randomized controlled trial.
S Khalid,Robert D. Murdoch,Amy Newlands,Kevin Smart,Angela Kelsall,Kimberley Holt,Rachel Dockry,Ashley Woodcock,Jaclyn A. Smith +8 more
TL;DR: This study raises important questions about both the role of TRVP1-mediated mechanisms in patients with refractory chronic cough and also the predictive value of capsaicin challenge testing in the assessment of novel antitussive agents.
Journal ArticleDOI
Response of Chronic Cough to Acid-Suppressive Therapy in Patients With Gastroesophageal Reflux Disease
TL;DR: Evidence suggests that rigorous patient selection is necessary to identify patient populations likely to be responsive to antireflux therapy, using physiologically timed cough events during reflux testing, minimal patient exclusion because of presumptive alternative diagnoses, and appropriate power to detect a modest therapeutic gain.
EAES recommendations for the management of gastroesophageal reflux disease Karl Hermann FuchsBenjamin BabicWolfram BreithauptBernard Dallemagne • Abe FingerhutEdgar FurneeFrank GranderathPeter Horvath • Peter KardosRudolph PointnerEdoardo SavarinoMaud Van Herwaarden-Lindeboom •
TL;DR: The European Association of Endoscopic Surgery (EAES) has tasked a group of experts, based on their clinical and scientific expertise in the field of Gastroesophageal reflux disease (GERD), to establish current guidelines in a consensus development conference as discussed by the authors.
Journal ArticleDOI
Controversies in the evaluation and management of chronic cough.
TL;DR: There is a pressing need to understand the genetic, molecular, and physiological basis of unexplained chronic cough and to develop novel antitussive drugs that down-regulate cough reflex sensitivity.
References
More filters
Book
Ambulatory care visits to physician offices, hospital outpatient departments, and emergency departments : United States, 1996
TL;DR: Utilization varied by patient age, sex, and race; Persons 75 years and over had the highest rate of ambulatory care visits; and Females had significantly higher rates of visits to physician offices and hospital outpatient departments than males did.
Journal ArticleDOI
ERS guidelines on the assessment of cough
Alyn H. Morice,Giovanni A. Fontana,Maria G. Belvisi,Surinder S. Birring,Kian Fan Chung,Peter V. Dicpinigaitis,J A Kastelik,Lorcan McGarvey,Jaclyn A. Smith,Milos Tatar,John Widdicombe +10 more
TL;DR: Cough can have profound effects on health status, which can be assessed by cough-specific health status questionnaires, and may be used to follow change in cough reflex sensitivity in an individual.
Journal ArticleDOI
The symptom-association probability: An improved method for symptom analysis of 24-hour esophageal pH data
Bas L.A.M. Weusten,J. M. M. Roelofs,Louis M. A. Akkermans,Gerard P. van Berge-Henegouwen,A. J. P. M. Smout +4 more
TL;DR: The SAP is a single, simple, quantitative measure of the strength of the association between symptoms and reflux episodes that is devoid of the disadvantages inherent to previously used methods.
Journal ArticleDOI
Prevalence, pathogenesis, and causes of chronic cough
Kian Fan Chung,Ian D. Pavord +1 more
TL;DR: Effective control of cough requires not only controlling the disease causing the cough but also desensitisation of cough pathways.
Journal ArticleDOI
Twenty-four hour ambulatory simultaneous impedance and pH monitoring: A multicenter report of normal values from 60 healthy volunteers
Steven S. Shay,Radu Tutuian,Daniel Sifrim,Marcelo F. Vela,James L. Wise,Nagammapudur S. Balaji,Xin Zhang,Talal Adhami,Joseph A. Murray,Jeffrey H. Peters,Donald O. Castell +10 more
TL;DR: This study characterizes the frequency, duration, and extent of reflux in health and provides normal values for 24-h Imp-pH for future comparison with GERD patients.