The role of coughing as a gastroesophageal-reflux provoking maneuver: the scintigraphical evaluation

Abstract

The results of our study showed that 39% (25 of 64) of the observed GER findings were achieved exclusively by means of cough provocation.

Intrathoracic airway obstruction and gastroesophageal reflux: A canine model

“…It has been argued that the combination of primary tracheomalacia with GER could be explained by the presence of certain defects in foregut separation, which leads to esophageal dysmotility 14, 15. It has also been speculated that cough, which occurs frequently in these patients because of trapped airway secretions, can aggravate GER by increasing intrabdominal pressure 16, 17. The wide variations in intrathoracic and intrabdominal pressures (IAP) related to the abnormal physiology of breathing in subjects with tracheomalacia were also stated as a possible mechanism 6.…”

“…14,15 It has also been speculated that cough, which occurs frequently in these patients because of trapped airway secretions, can aggravate GER by increasing intrabdominal pressure. 16,17 The wide variations in intrathoracic and intrabdominal pressures (IAP) related to the abnormal physiology of breathing in subjects with tracheomalacia were also stated as a possible mechanism. 6 Although a significant increase in transdiphragmatic pressure which overcomes lower esophageal sphincter (LES) pressure, was postulated as the cause of GER, none of these studies were designed to provide the physiological proof for this speculation.…”

An objective study of acid reflux and cough in children using an ambulatory pHmetry-cough logger

“…However, there are few objective studies and no ambulatory studies in children. The sole objective study in children used scintigraphy16 and examined non-spontaneous cough (ie, cough on command). Our current study is the first in children in an ambulatory real-life setting that has quantified the relationship between acid GER episodes and cough objectively.…”

“…Few ambulatory studies exist that evaluate the relationship between cough and reflux objectively. Indeed, there are no published ambulatory objective studies in children, and the only objective study in children showed that cough induces reflux 16. All ambulatory objective studies to date have used manometry17–20 to quantify cough that is based on alterations in intraoesophageal pressure reflecting the increase in intrathoracic pressures that occur with the expiratory phase of cough.…”

Gastroesophageal Reflux Disease

“…Kronik öksürük epizotları sırasında intraabdominal basınç artarak özellikle bazal alt özofagus sfinkter basıncının düşük olduğu veya hiatal herni varlığında alt özofagus sfinkter basıncını aşabilir. Çocuklarda yeni yapılmış bir sintigrafi çalışmasında klinik olarak reflü şüphesi olan olguların istemli öksürük sırasında %51.6'sında özofageal reflü saptanmıştır [38]. Tüm nedenler göz önüne alındığında reflü durumlarının en sık nedeni TLESR'dır.…”