Abstract
Gastro-oesophageal reflux (GOR) is a common cause respiratory symptom, particularly chronic cough and its assessment is a key component of cough management guidelines. GOR may be suspected in a patient complaining of heartburn but it is often unclear if GOR and cough are causally linked since GOR is prevalent in the general population. Furthermore, typical symptoms of GOR may be absent and cough may be the only manifestation. The assessment of patients may therefore require objective demonstration of GOR and its relationship with respiratory symptoms. The most widely used tools are oesophageal pH and impedance monitors and manometry. Cough is usually recorded by the patient with an event marker or detected during oesophageal manometry from increases in oesophageal pressure. These methods have recently been shown to be inaccurate for counting coughs. The development of validated, objective cough monitors has led to an improved understanding of the relationship between GOR and cough when used together with oesophageal tests. Whilst patients with cough and GOR do have some coughs events that are preceded GOR, a similar number of coughs follow GOR events or are unrelated. Further studies are needed to determine whether the demonstration of a temporal relationship is clinically useful. The ability to predict a good response to anti-GOR therapy would support a role of such tests in clinical practice.
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Pandya, A.K., Kavanagh, J.E., Birring, S.S. (2018). Cough Monitoring in Reflux Lung Disease. In: Morice, A., Dettmar, P. (eds) Reflux Aspiration and Lung Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-90525-9_11
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