Comparison of clinical characteristics of chronic cough due to non-acid and acid gastroesophageal reflux.

Abstract

BACKGROUND AND OBJECTIVE:

Little is known about non-acid gastroesophageal reflux-induced chronic cough (GERC). The purpose of the study is to explore the clinical characteristics of non-acid GERC.

METHODS:

Clinical symptoms, cough symptom score, capsaicin cough sensitivity, gastroesophageal reflux diagnostic questionnaire (GerdQ) score, findings of multichannel intraluminal impedance-pH monitoring (MII-pH) and response to pharmacological anti-reflux therapy were retrospectively reviewed in 38 patients with non-acid GERC and compared with those of 49 patients with acid GERC.

RESULTS:

Non-acid GERC had the similar cough character, cough symptom score, and capsaicin cough sensitivity to acid GERC. However, non-acid GERC had less frequent regurgitation (15.8% vs 57.1%, χ(2)  = 13.346, P = 0.000) and heartburn (7.9% vs 32.7%, χ(2)  = 7.686, P  = 0.006), and lower GerdQ score (7.4 ± 1.4 vs 10.6 ± 2.1, t = -6.700, P = 0.003) than acid GERC. Moreover, MII-pH revealed more weakly acidic reflux episodes, gas reflux episodes and a higher symptom association probability (SAP) for non-acid reflux but lower DeMeester score, acidic reflux episodes and SAP for acid reflux in non-acid GERC than in acid GERC. Non-acid GERC usually responded to the standard anti-reflux therapy but with delayed cough resolution or attenuation when compared with acid GERC. Fewer patients with non-acid GERC needed an augmented acid suppressive therapy or treatment with baclofen.

CONCLUSIONS:

There are some differences in the clinical manifestations between non-acid and acid GERC, but MII-pH is essential to diagnose non-acid GERC.

• Authors: Xianghuai Xu, Zhongmin Yang, Qiang Chen, Li Yu, Siwei Liang, Hanjing Lü, Zhongmin Qiu
• Journal: The clinical respiratory journal (Clin Respir J) Vol. 9 Issue 2 Pg. 196-202 (Apr 2015) ISSN: 1752-699X [Electronic] England
• PMID: 24898575 (Publication Type: Clinical Study, Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2014 John Wiley & Sons Ltd.

Chemical References

• Anti-Ulcer Agents
• Muscle Relaxants, Central
• Domperidone
• Baclofen
• Omeprazole
• Capsaicin

Topics

• Adult
• Anti-Ulcer Agents (therapeutic use)
• Baclofen (therapeutic use)
• Capsaicin
• Chronic Disease
• Cough (diagnosis, etiology, therapy)
• Domperidone (therapeutic use)
• Esophageal pH Monitoring
• Female
• Gastroesophageal Reflux (complications, diagnosis, therapy)
• Humans
• Male
• Middle Aged
• Muscle Relaxants, Central (therapeutic use)
• Omeprazole (therapeutic use)
• Retrospective Studies
• Surveys and Questionnaires