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Gastrointestinal Tract: Assessment and Treatment of Cough

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Diagnosis and Treatment of Chronic Cough

Abstract

Gastroesophageal reflux is closely associated with cough and is a common etiology of chronic cough. Cough due to reflux can be elicited by acidic and non-acidic reflux, and its assessment and diagnosis are a process to establish a cause–effect relation between reflux and cough, with esophageal impedance–pH monitoring as a gold standard for the detection of abnormal reflux. The favorable response to anti-reflux treatment is a key step to confirm reflux as the cause of chronic cough. In addition to lifestyle modification, pharmacological anti-reflux therapy is a first-line choice, and anti-reflux surgery is a promising option for cure.

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References

  1. Jaspersen D, Kulig M, Labenz J, et al. Prevalence of extra-oesophageal manifestations in gastro-oesophageal reflux disease: an analysis based on the ProGERD Study. Aliment Pharmacol Ther. 2003;17:1515–20.

    Article  CAS  Google Scholar 

  2. Lee JH, Park SY, Cho SB, et al. Reflux episode reaching the proximal esophagus are associated with chronic cough. Gut Liver. 2012;6:197–202.

    Article  Google Scholar 

  3. Vakil N, Van Zanten SV, Kahrilas P, et al. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol. 2006;101:1900–20.

    Article  Google Scholar 

  4. Lai K, Shen H, Zhou X, et al. Clinical practice guidelines for diagnosis and management of cough – Chinese Thoracic Society (CTS) Asthma Consortium. J Thorac Dis. 2018;10:6314–51.

    Article  Google Scholar 

  5. Kahrilas PJ, Altman KW, Chang AB, et al. Chronic cough due to gastroesophageal reflux in adults: CHEST Guideline and Expert Panel Report. Chest. 2016;150:1341–60.

    Article  Google Scholar 

  6. Morice AH, Millqvist E, Bieksiene K, et al. ERS guidelines on the diagnosis and treatment of chronic cough in adults and children. Eur Respir J. 2020;55(1):1901136.

    Article  CAS  Google Scholar 

  7. Irwin RS. Chronic cough due to gastroesophageal reflux disease: ACCP evidence-based clinical practice guidelines. Chest. 2006;129:80S–94S.

    Article  Google Scholar 

  8. Lai K, Chen R, Lin J, et al. A prospective, multicenter survey on causes of chronic cough in China. Chest. 2013;143:613–20.

    Article  Google Scholar 

  9. Ding H, Xu X, Wen S, et al. Changing etiological frequency of chronic cough in a tertiary hospital in Shanghai, China. J Thorac Dis. 2019;11:3482–9.

    Article  Google Scholar 

  10. Molyneux ID, Morice AH. Airway reflux, cough and respiratory disease. Ther Adv Chronic Dis. 2011;2:237–48.

    Article  Google Scholar 

  11. Patterson N, Mainie I, Rafferty G, et al. Nonacid reflux episodes reaching the pharynx are important factors associated with cough. J Clin Gastroenterol. 2009;43:414–9.

    Article  Google Scholar 

  12. Song WJ, Chang YS, Morice AH. Changing the paradigm for cough: does ‘cough hypersensitivity’ aid our understanding? Asia Pac Allergy. 2014;4:3–13.

    Article  Google Scholar 

  13. Qiu Z, Yu L, Xu S, et al. Cough reflex sensitivity and airway inflammation in patients with chronic cough due to non-acid gastro-esophageal reflux. Respirology. 2011;16:645–52.

    Article  Google Scholar 

  14. Xu X, Yang Z, Chen Q, et al. Comparison of clinical characteristics of chronic cough due to non-acid and acid gastroesophageal reflux. Clin Respir J. 2015;9:196–202.

    Article  Google Scholar 

  15. Herregods TVK, Pauwels A, Jafari J, et al. Ambulatory pH-impedance-pressure monitoring as a diagnostic tool for the reflux–cough syndrome. Dis Esophagus. 2018;31:1–7.

    Article  CAS  Google Scholar 

  16. Gyawali CP, Kahrilas PJ, Savarino E, et al. Modern diagnosis of GERD: the Lyon Consensus. Gut. 2018;67:1351–62.

    Article  Google Scholar 

  17. Ummarino D, Vandermeulen L, Roosens B, et al. Gastroesophageal reflux evaluation in patients affected by chronic cough: restech versus multichannel intraluminal impedance/pH metry. Laryngoscope. 2013;123:980–4.

    Article  Google Scholar 

  18. Armstrong D, Bennett JR, Blum AL, et al. The endoscopic assessment of oesophagits: a progress report on observer agreement. Gastroenterology. 1996;111:85–92.

    Article  CAS  Google Scholar 

  19. Kopeo S, Ma J, Ferrucci J. The sensitivity and specificity of barium swallow in diagnosing gastroesophageal reflux in patients with chronic cough. Chest. 2013;144(4_MeetingAbstracts):525A.

    Google Scholar 

  20. Decalmer S, Stovold R, Houghton LA, et al. Chronic cough: relationship between microaspiration, gastroesophageal reflux, and cough frequency. Chest. 2012;142:958–64.

    Article  Google Scholar 

  21. Kitz R, Boehles HJ, Rosewich M, et al. Lipid-laden alveolar macrophages and pH monitoring in gastroesophageal reflux-related respiratory symptoms. Pulm Med. 2012;673637:2012.

    Google Scholar 

  22. Xu X, Chen Q, Liang S, et al. Comparison of gastroesophageal reflux disease questionnaire and multichannel intraluminal impedance pH monitoring in identifying patients with chronic cough responsive to antireflux therapy. Chest. 2014;145:1264–70.

    Article  Google Scholar 

  23. Katz PO, Gerson LB, Vela MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2013;108:308–28.

    Article  Google Scholar 

  24. Smith JE, Morjaria JB, Morice AH. Dietary intervention in the treatment of patients with cough and symptoms suggestive of airways reflux as determined by Hull airways Reflux Questionnaire. Cough. 2013;9:27.

    Article  Google Scholar 

  25. Khan BA, Sodhi JS, Zargar SA, et al. Effect of bed head elevation during sleep in symptomatic patients of nocturnal gastroesophageal reflux. J Gastroenterol Hepatol. 2012;27:1078–82.

    Article  Google Scholar 

  26. Chandra KM, Harding SM. Therapy insight: treatment of gastroesophageal reflux in adults with chronic cough. Nat Clin Pract Gastroenterol Hepatol. 2007;4:604–13.

    Article  Google Scholar 

  27. Shaheen NJ, Crockett SD, Bright SD, et al. Randomised clinical trial: high-dose acid suppression for chronic cough-a double-blind, placebo-controlled study. Aliment Pharmacol Ther. 2011;33:225–34.

    Article  CAS  Google Scholar 

  28. Faruqi S, Molyneux ID, Fathi H, Wright C, Thompson R, Morice AH. Chronic cough and esomeprazole: a double-blind placebo-controlled parallel study. Respirology. 2011;16:1150–6.

    Article  Google Scholar 

  29. Kahrilas PJ, Howden CW, Hughes N, et al. Response of chronic cough to acid-suppressive therapy in patients with gastroesophageal reflux disease. Chest. 2013;143:605–12.

    Article  CAS  Google Scholar 

  30. Lv HJ, Qiu ZM. Refractory chronic cough due to gastroesophageal reflux: definition, mechanism and management. World J Methodol. 2015;5:149–56.

    Article  Google Scholar 

  31. Vela MF, Tutuian R, Katz PO, et al. Baclofen decreases acid and non-acid post-prandial gastroesophageal reflux measured by combined multichannel intraluminal impedance and pH. Aliment Pharmacol Ther. 2003;17:243–51.

    Article  CAS  Google Scholar 

  32. Madanick RD. Management of GERD-related chronic cough. Gastroenterol Hepatol (NY). 2013;9:311–3.

    Google Scholar 

  33. Xu XH, Yang ZM, Chen Q, et al. Therapeutic efficacy of baclofen in refractory gastroesophageal reflux-induced chronic cough. World J Gastroenterol. 2013;19:4386–92.

    Article  Google Scholar 

  34. Xu X, Lv H, Yu L, et al. A stepwise protocol for the treatment of refractory gastroesophageal reflux-induced chronic cough. J Thorac Dis. 2016;8:178–85.

    PubMed  PubMed Central  Google Scholar 

  35. Dong R, Xu X, Yu L, et al. Randomised clinical trial: gabapentin vs baclofen in the treatment of suspected refractory gastro–oesophageal reflux-induced chronic cough. Aliment Pharmacol Ther. 2019;49:714–22.

    Article  CAS  Google Scholar 

  36. Gawron AJ, Kahrilas PJ, Pandolfino JE. Chronic cough: a gastroenterology perspective. Curr Opin Otolaryngol Head Neck Surg. 2013;21:523–9.

    PubMed  PubMed Central  Google Scholar 

  37. Lugaresi M, Aramini B, Daddi N, et al. Effectiveness of antireflux surgery for the cure of chronic cough associated with gastroesophageal reflux disease. World J Surg. 2015;39:208–15.

    Article  Google Scholar 

  38. Allen CJ, Anvari M. Does laparoscopic fundoplication provide long-term control of gastroesophageal reflux related cough? Surg Endosc. 2004;18:633–7.

    Article  CAS  Google Scholar 

  39. Liang WT, Wu JM, Wang F, et al. Stretta radiofrequency for gastroesophageal reflux disease-related respiratory symptoms: a prospective 5-year study. Minerva Chir. 2014;69:293–9.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji University School of Medicine, Shanghai, China

    Qiang Chen & Zhongmin Qiu

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  1. Qiang Chen
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  2. Zhongmin Qiu
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Correspondence to Zhongmin Qiu .

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Editors and Affiliations

  1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea (Republic of)

    Sang Heon Cho

  2. Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (Republic of)

    Woo-Jung Song

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Chen, Q., Qiu, Z. (2021). Gastrointestinal Tract: Assessment and Treatment of Cough. In: Cho, S.H., Song, WJ. (eds) Diagnosis and Treatment of Chronic Cough. Springer, Singapore. https://doi.org/10.1007/978-981-33-4029-9_6

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  • DOI: https://doi.org/10.1007/978-981-33-4029-9_6

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-33-4028-2

  • Online ISBN: 978-981-33-4029-9

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