Comparison of clinical characteristics of chronic cough due to non‐acid and acid gastroesophageal reflux. (20th March 2014)

• Record Type: Journal Article
• Authors: Xu, Xianghuai; Yang, Zhongmin; Chen, Qiang; Yu, Li; Liang, Siwei; Lü, Hanjing; Qiu, Zhongmin
• Is Part Of: Clinical respiratory journal. Volume 9:Number 2(2015)
• Page Start: 196
• Page End: 202
• Publication Date: 2014-03-20
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiratory organs -- Periodicals; 616.24
• DOI: 10.1111/crj.12124
• Languages: English
• ISSNs: 1752-6981

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="crj12124-sec-0001" sec-type="section"> <title>Background and Objective</title> <p>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.</p> </sec> <sec id="crj12124-sec-0002" sec-type="section"> <title>Methods</title> <p>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.</p> </sec> <sec id="crj12124-sec-0003" sec-type="section"> <title>Results</title> <p>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<sup>2</sup> = 13.346, <italic>P</italic> = 0.000) and heartburn (7.9% vs 32.7%, χ<sup>2</sup> = 7.686, <italic>P</italic> = 0.006), and lower GerdQ score (7.4 ± 1.4 vs 10.6 ± 2.1, <italic>t</italic> = −6.700, <italic>P</italic> = 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.</p> </sec> <sec id="crj12124-sec-0004" sec-type="section"> <title>Conclusions</title> <p>There are some differences in the clinical manifestations between non‐acid and acid GERC, but MII‐pH is essential to diagnose non‐acid GERC.</p> </sec> </abstract>