Reflux pattern and role of impedance‐pH variables in predicting PPI response in patients with suspected GERD‐related chronic cough. Issue 8 (11th August 2014)

• Record Type: Journal Article
• Authors: Ribolsi, M.; Savarino, E.; De Bortoli, N.; Balestrieri, P.; Furnari, M.; Martinucci, I.; Casale, M.; Greco, F.; Salvinelli, F.; Savarino, V.; Marchi, S.; Cicala, M.
• Is Part Of: Alimentary pharmacology & therapeutics. Volume 40:Issue 8(2014)
• Page Start: 966
• Page End: 973
• Publication Date: 2014-08-11
• Subjects: Digestive organs -- Diseases -- Treatment -- Periodicals; Digestive organs -- Effect of drugs on -- Periodicals; Gastrointestinal system -- Diseases -- Treatment -- Periodicals; Gastrointestinal system -- Effect of drugs on -- Periodicals; 615.73
• DOI: 10.1111/apt.12919
• Languages: English
• ISSNs: 0269-2813

Abstract

<abstract abstract-type="main" id="apt12919-abs-0001"> <title>Summary</title> <sec id="apt12919-sec-0001" sec-type="section"> <title>Background</title> <p>Gastro‐oesophageal reflux disease (GERD) may contribute to the onset of chronic cough (CC); however, the multichannel intraluminal impedance‐pH (MII‐pH) monitoring is often within the normal range and the response to proton pump inhibitors (PPIs) unsatisfactory. The measure of impedance baseline (IB) increases the sensitivity of MII‐pH in patients with typical symptoms.</p> </sec> <sec id="apt12919-sec-0002" sec-type="section"> <title>Aim</title> <p>To evaluate the role of MII‐pH variables, including IB, in predicting PPI response and to define the characteristics of the reflux pattern in CC patients.</p> </sec> <sec id="apt12919-sec-0003" sec-type="section"> <title>Methods</title> <p>Prospectively selected CC patients suspected GERD‐related underwent MII‐pH monitoring and, therefore, received a double dose of PPIs for at least 6 weeks. Patients filled symptom scores before MII‐pH and after PPI therapy. MII‐pH data were compared with those obtained in 60 non‐erosive reflux disease patients with typical symptoms.</p> </sec> <sec id="apt12919-sec-0004" sec-type="section"> <title>Results</title> <p>A total of 156 CC patients entered the study: 68 (43.5%) responders and 88 (56.5%) nonresponders to PPIs. The number of reflux episodes was significantly higher in CC compared with that in typical symptoms patients. Nonresponder CC patients with a pathological acid exposure time (AET) and/or IB value were 43/88 (49%), while 15/88 (17%) presented only pathological AET (<italic>P </italic>< 0.001). CC patients with a pathological AET or IB, or with both a pathological AET and IB, showed a probability of PPI response twofold greater than patients with normal AET and IB.</p> </sec> <sec id="apt12919-sec-0005" sec-type="section"> <title>Conclusions</title> <p>The presence of a pathological AET or pathological IB in CC patients is associated with a greater probability of PPI response. IB is a promising variable in patients with CC, as it increases the diagnostic yield of MII‐pH and allows confirmation of the GERD diagnosis in these patients.</p> </sec> </abstract>