Chronic Persistent Cough and Clearance of Esophageal Acid

Ing, Alvin; Ngu, Meng C.; Breslin, A. B. X.

doi:10.1378/chest.102.6.1668

Cited by 52 publications

(28 citation statements)

References 7 publications

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“…The explanation for the lack of significant improvement in cough during omeprazole treatment in these patients is that there were two whose cough worsened whilst on omeprazole and seven whose cough was relieved by omeprazole. Although it is widely accepted that GOR causes cough [1±7] there is also evidence that cough may promote GOR [8,11,13]. It has been proposed that a positive feedback cycle between cough and GOR might exist [8,11].…”

Section: Discussionmentioning

confidence: 99%

“…Although it is widely accepted that GOR causes cough [1±7] there is also evidence that cough may promote GOR [8,11,13]. It has been proposed that a positive feedback cycle between cough and GOR might exist [8,11]. Lack of symptoms in these patients when on placebo might be explained by omeprazole-induced suppression of such a cough-reflux selfperpetuating cycle.…”

Section: Discussionmentioning

confidence: 99%

“…Two mechanisms by which GOR can cause cough have been proposed: hypopharyngeal reflux and even aspiration of oesophageal contents [9±10], and acid in the distal oesophagus stimulating the oesophageal-tracheobronchial cough reflex [7,11,12]. There is also evidence that cough might promote GOR [13], probably by increasing the pressure gradient between the thorax and the abdomen or by causing transient lower oesophageal sphincter relaxation [8,11].…”

mentioning

confidence: 99%

“…There is also evidence that cough might promote GOR [13], probably by increasing the pressure gradient between the thorax and the abdomen or by causing transient lower oesophageal sphincter relaxation [8,11]. In fact, the presence of a coughreflux self-perpetuating cycle has been proposed [8,11].…”

mentioning

confidence: 99%

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Chronic cough and gastro-oesophageal reflux: a double-blind placebo-controlled study with omeprazole

Kiljander¹,

Salomaa²,

Hietanen³

et al. 2000

Eur Respir J

137

105

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Gastro-oesophageal reflux (GOR) is an important cause of chronic cough. There has been a lack of placebo-controlled trials treating GOR related chronic cough with antireflux therapy. The aim of this study was to determine the efficacy of omeprazole on GOR related chronic cough.After excluding other common causes of cough, oesophageal pH monitoring was performed on 48 patients with chronic cough. Twenty-nine patients found to have GOR were randomized in a double-blind fashion to receive omeprazole 40 mg o.d. or placebo for 8 weeks. After a 2-week washout period, patients were crossed over to the other treatment. Symptoms were recorded daily in a diary.Twenty-one patients completed both treatment periods. Cough (p=0.02) and gastric symptoms (p=0.003) improved significantly during the omeprazole treatment in twelve patients who received placebo during the first and omeprazole during the second 8-week period. In nine patients who received omeprazole during the first 8-week period, amelioration in cough reached statistical significance only after cessation of omeprazole. Gastric symptoms also remained minor during placebo in these nine patients.Omeprazole 40 mg o.d. seems to improve chronic cough in patients with gastrooesophageal reflux and the effect of omeprazole in ameliorating both cough and reflux symptoms continues after treatment ceases. Eur Respir J 2000; 16: 633±638.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Chronic cough and gastro-oesophageal reflux: a double-blind placebo-controlled study with omeprazole

Kiljander¹,

Salomaa²,

Hietanen³

et al. 2000

Eur Respir J

137

105

View full text Add to dashboard Cite

show abstract

“…Stimulation of vagally innervated oesophageal receptors [62], dysmotility [63], and/or aspiration of refluxed gastric content [64] are regarded as the primary causes of GOR-related cough. Whilst a history of classic GOR symptoms, such as heartburn, may be helpful in suggesting the diagnosis, cough due to GOR may be an isolated symptom [63][64][65].…”

Section: Cough and Gastro-oesophageal Refluxmentioning

confidence: 99%