The Utility of Ambulatory pH Monitoring in Patients Presenting with Chronic Cough and Asthma

AlHabib, Khalid F.; Vedal, Sverre; Champion, P; FitzGerald, J. Mark

doi:10.1155/2007/985491

Cited by 11 publications

(7 citation statements)

References 30 publications

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“…4 Along with asthma and postnasal drip syndrome, GERD is 1 of the 3 most common causes of chronic unexplained cough. 5,6 Successful management intuitively requires accurate suspicion of the cause-and-effect relationship between reflux events and chronic cough. Practice guidelines suggest initiating prolonged maximal empiric acid suppression therapy when suspicion of chronic cough induced by GERD is high, with variable symptom response.…”

mentioning

confidence: 99%

Long-term Therapeutic Outcome of Patients Undergoing Ambulatory pH Monitoring for Chronic Unexplained Cough

Hersh

Sayuk

Gyawali

2010

Journal of Clinical Gastroenterology

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Background and Aim Ambulatory pH monitoring is frequently performed to determine temporal associations between reflux events and chronic unexplained cough. We further explored the clinical value of ambulatory pH monitoring in predicting long-term symptomatic outcome of therapy in chronic cough. Methods Symptom scores and reflux indicators from ambulatory pH study [acid exposure time, symptom association probability (SAP), and symptom index] were extracted from records of subjects undergoing esophageal evaluation for chronic cough. Intensity of antireflux therapy administered and symptomatic outcome were determined by telephone interview. Univariate and logistic regression analysis were performed to identify predictors of a high degree response (HDR), defined as sustained, durable symptom improvement lasting >3 months. Results Fifty-three subjects (mean age 63 ± 2 y, 42 females) fulfilled the inclusion criteria. Reflux parameters were abnormal on ambulatory pH monitoring in 54.7%. After a mean interval of 3 ± 0.3 years, cough intensity improved significantly, 19 subjects (35.8%) achieving HDR. Only female sex and positive SAP predicted HDR on univariate analysis; SAP and intensity of antireflux therapy were retained as independent predictors (P ≤ 0.03) on logistic regression analysis. Sequential use of acid exposure time, SAP, and symptom index had the best value, with the highest likelihood of HDR when all three were positive (85.7%, P < 0.01). Conclusions Reflux disease is a frequent cause of chronic unexplained cough and aggressive antireflux therapy forms a vital component of management. Positive SAP is an independent predictor of outcome, but hierarchical or sequential use of abnormal gastroesophageal reflux disease parameters on ambulatory pH testing has value in predicting long-term symptomatic response.

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mentioning

confidence: 99%

Long-term Therapeutic Outcome of Patients Undergoing Ambulatory pH Monitoring for Chronic Unexplained Cough

Hersh

Sayuk

Gyawali

2010

Journal of Clinical Gastroenterology

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“…Мониторирование рН проводят также пациентам с внепищеводными проявлениями ГЭРБ (некардиальные боли в груди, бронхоспазм или приступ бронхиальной астмы, не купирующийся базисной терапией, охриплость, хронический кашель, ларингит, фарингит, гранулёмы голосовых связок), что дает возможность определить возможную взаимосвязь ГЭР и симптомов, а в ряде случаев оценить ответ на провокационные тесты. Проведение суточной рН-метрии показано с целью оценки эффективности терапевтического лечения, а также до и после фундопликации для контроля хирургического антирефлюксного лечения [16].…”

Section: таблицаunclassified

Clinical impact of 24-hour pH-metry in esophageal and stomach diseases diagnostics and pharmacological drugs efficacy testing

Трухманов¹,

Сторонова²,

Ивашкин³

2016

Ross. ž. gastroènterol. gepatol. koloproktol.

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Национальная школа гастроэнтерологов, гепатологов National college of gastroenterologists, hepatologists Сторонова Ольга Андреевна -кандидат медицинских наук, врач отделения функциональной диагностики Клиники пропедевтики внутренних болезней, гастроэнтерологии и гепатологии им. В. Х. Василенко ФГБОУ ВО «Первый Московский государственный медицинский университет им. И. М. Сеченова».

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“…In a retrospective analysis of pH-monitoring results in a referral center in Canada, pathologic esophageal acid exposures were found in 52% of 133 patients with chronic cough [ 6 ]. Using a second pH probe, pathologic acid exposure in the proximal esophagus was also present in 52% of the patients.…”

Section: Role Of Weakly Acidic Refl Ux and Objective Cough Detectionmentioning

confidence: 99%

Reflux cough

Blondeau¹,

Sifrim²,

Dupont³

et al. 2008

Curr Gastroenterol Rep

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Cough can be an extraesophageal manifestation of gastroesophageal reflux disease. This article summarizes recent progress in our understanding of the pathophysiology, diagnosis, and treatment of the reflux cough syndrome. Recent studies have provided further evidence for a role of weakly acidic gastroesophageal reflux in inducing cough. It has also been established that although reflux may induce cough, cough may also trigger reflux in some patients, and distinguishing between the two requires objective detection of cough burst (ie, by esophageal manometry). Treatment of the reflux cough syndrome is an issue of ongoing controversy and further studies.

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The Utility of Ambulatory pH Monitoring in Patients Presenting with Chronic Cough and Asthma

Cited by 11 publications

References 30 publications

Long-term Therapeutic Outcome of Patients Undergoing Ambulatory pH Monitoring for Chronic Unexplained Cough

Long-term Therapeutic Outcome of Patients Undergoing Ambulatory pH Monitoring for Chronic Unexplained Cough

Clinical impact of 24-hour pH-metry in esophageal and stomach diseases diagnostics and pharmacological drugs efficacy testing

Reflux cough

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