Skip to main content
SpringerLink
Log in
Book cover

Reflux Aspiration and Lung Disease pp 71–78Cite as

Effect of Reflux on Cough Sensitivity and Bronchial Responsiveness

  • Chapter
  • First Online:

  • 603 Accesses

Abstract

Gastroesophageal reflux is an extremely common condition often associated with chronic cough, dyspnea, laryngeal discomfort, and other extraesophageal symptoms. A considerable body of evidence has established an association of reflux with the presence of cough reflex hypersensitivity and/or bronchial hyperresponsiveness. However, the demonstration of such airway hyperreactivity does not uniformly predict the presence of underlying pathology nor the occurrence of symptoms. Furthermore, treatment aimed at suppressing cough reflex sensitivity or bronchial responsiveness, even when successful, often fails to ameliorate associated symptoms. Given that reflux, cough, and asthma are all very common conditions, the association of reflux with cough reflex hypersensitivity and bronchial hyperresponsiveness is likely causal in some individuals and coincidental in others. Adequately performed clinical trials evaluating the presence of pathological reflux, its effect on cough reflex sensitivity, airway responsiveness and pulmonary symptoms, as well as objective and symptomatic response to therapeutic interventions, will be most useful in elucidating the pathophysiologic manifestations of reflux on the respiratory system.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Faruqi S, Molyneux ID, Fathi H, Wright C, Thompson R, Morice AH. Chronic cough and esomeprazole: a double-blind placebo-controlled parallel study. Respirology. 2011;16:1150–6.

    Article  PubMed  Google Scholar 

  2. Shaheen NJ, Crockett SD, Bright SD, Madanick RD, Buckmire R, Couch M, et al. Randomised clinical trial: high-dose acid suppression for chronic cough-a double-blind, placebo-controlled study. Aliment Pharmacol Ther. 2011;33:225–34.

    Article  CAS  PubMed  Google Scholar 

  3. American Lung Association Asthma Clinical Research Centers, Mastronarde JG, Anthonisen NR, Castro M, Holbrook JT, Leone FT, Teague WG, et al. Efficacy of esomeprazole for treatment of poorly controlled asthma. N Engl J Med. 2009;360:1487–99.

    Article  PubMed Central  Google Scholar 

  4. Chan WW, Chiou E, Obstein KL, Tignor AS, Whitlock TL. The efficacy of proton pump inhibitors for the treatment of asthma in adults: a meta-analysis. Arch Intern Med. 2011;171:620–9.

    Article  CAS  PubMed  Google Scholar 

  5. Kiljander TO, Junghard O, Beckman O, Lind T. Effect of esomeprazole 40 mg once or twice daily on asthma: a randomized, placebo-controlled study. Am J Respir Crit Care Med. 2010;181:1042–8.

    Article  CAS  PubMed  Google Scholar 

  6. Smid SD, Page AJ, O’Donnell T, Langman J, Rowlan R, Blackshaw LA. Oesophagitis-induced changes in capsaicin-sensitive tachykininergic pathways in the ferret lower oesophageal sphincter. Neurogastroenterol Motil. 1998;10:403–11.

    Article  CAS  PubMed  Google Scholar 

  7. Zhang S, Liu Z, Heldsinger A, Owyang C, Yu S. Intraluminal acid activates esophageal nodose C fibers after mast cell activation. Am J Physiol Gastrointest Liver Physiol. 2014;306:G200–7.

    Article  CAS  PubMed  Google Scholar 

  8. Yu X, Hu Y, Yu S. Effects of acid on vagal nociceptive afferent subtypes in guinea pig esophagus. Am J Physiol Gastrointest Liver Physiol. 2014;307:G471–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Morice AH, Fontana GA, Belvisi MG, Birring SS, Chung KF, Dicpinigaitis PV, Kastelik JA, McGarvey LP, Smith JA, Tatar M, Widdicombe J. European Respiratory Society Task Force. ERS guidelines on the assessment of cough. Eur Respir J. 2007;29:1256–76.

    Article  CAS  PubMed  Google Scholar 

  10. Javorkova N, Varechova S, Pecova R, Tatar M, Balaz D, Demeter M, et al. Acidification of the esophagus acutely increases the cough sensitivity in patients with gastro-oesophageal reflux and chronic cough. Neurogastroenterol Motil. 2008;20:119–24.

    PubMed  CAS  Google Scholar 

  11. Wu DN, Yamauchi K, Kobayashi H, Tanifuli Y, Kato C, Suzuki K, et al. Effects of esophageal acid perfusion on cough responsiveness in patients with bronchial asthma. Chest. 2002;122:505–9.

    Article  PubMed  Google Scholar 

  12. Ferrari M, Olivieri M, Sembenini C, Benini L, Zuccali V, Bardelli E, et al. Tussive effect of capsaicin in patients with gastroesophageal reflux without cough. Am J Respir Crit Care Med. 1995;151:557–61.

    Article  CAS  PubMed  Google Scholar 

  13. Qiu Z, Yu L, Xu S, Liu B, Zhao T, Lu H, et al. Cough reflex sensitivity and airway inflammation in patients with chronic cough due to non-acid gastro-esophageal reflux. Respirology. 2011;16:645–52.

    Article  PubMed  Google Scholar 

  14. Xu X, Yang Z, Chen Q, Yu L, Liang S, Lu H, et al. Comparison of clinical characteristics of chronic cough due to non-acid and acid gastroesophageal reflux. Clin Respir J. 2015;9:196–202.

    Article  PubMed  Google Scholar 

  15. Varechova S, Mikler J, Murgas D, Dragula M, Banovcin P, Hanacek J. Cough reflex sensitivity in children with suspected and confirmed gastroesophageal reflux disease. J Physiol Pharmacol. 2007;58(Suppl 5;Pt 2):717–27.

    PubMed  Google Scholar 

  16. Ferrari M, Benini L, Brotto E, Locatelli F, De Iorio F, Bonella F, et al. Omeprazole reduces the response to capsaicin but not to methacholine in asthmatic patients with proximal reflux. Scand J Gastroenterol. 2007;42:299–307.

    Article  CAS  PubMed  Google Scholar 

  17. Benini L, Ferrari M, Sembenini C, Olivieri M, Micciolo R, Zuccali V, et al. Cough threshold in reflux oesophagitis: influence of acid and of laryngeal and oespophageal damage. Gut. 2000;46:762–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. O’Connell F, Thomas VE, Pride NB, Fuller RW. Capsaicin cough sensitivity decreases with successful treatment of chronic cough. Am J Respir Crit Care Med. 1994;150:374–80.

    Article  PubMed  Google Scholar 

  19. Torrego A, Cimbollek S, Hew M, Chung KF. No effect of omeprazole on pH of exhaled breath condensate in cough associated with gastro-esophageal reflux. Cough. 2005;1:10.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Nieto L, de Diego A, Perpina M, Compte L, Garrigues V, Martinez E, et al. Cough reflex testing with inhaled capsaicin in the study of chronic cough. Respir Med. 2003;97:393–400.

    Article  CAS  PubMed  Google Scholar 

  21. Herrera-Lopez JA, Mejia-Rivas MA, Vargas-Vorachkova F, Valdovinos-Diaz MA. Capsaicin induction of esophageal symptoms in different phenotypes of gastroesophageal reflux disease. Rev Gastroenterol Mex. 2010;75:396–404.

    PubMed  CAS  Google Scholar 

  22. Kindt S, Vos R, Blondeau K, Tack J. Influence of intra-oesophageal capsaicin instillation on heartburn induction and oesophageal sensitivity in man. Neurogastroenterol Motil. 2009;21:1032–e82.

    Article  CAS  PubMed  Google Scholar 

  23. Rodriguez-Stanley S, Collings KL, Robinson M, Owen W, Miner PB. The effects of capsaicin on reflux, gastric emptying and dyspepsia. Aliment Pharmacol Ther. 2000;14:129–34.

    Article  CAS  PubMed  Google Scholar 

  24. Grossi L, Cappello G, Marzio L. Effect of an acute intraluminal administration of capsaicin on oesophageal motor pattern in GORD patients with ineffective oesophageal motility. Neurogastroenterol Motil. 2006;18:632–6.

    Article  CAS  PubMed  Google Scholar 

  25. Dariusz Z, Wojciech J, Jozef D, Andrzej K, Jacek C, Jan C, et al. Assessment of cough threshold in patients with gastroesophageal reflux disease [article in Polish]. Pneumonol Alergol Pol. 2003;71:221–9.

    PubMed  Google Scholar 

  26. Ziora D, Jarosz W, Dzielicki J, Ciekalski J, Krzywiecki A, Dworniczak S, et al. Citric acid cough threshold in patients with gastroesophageal reflux disease rises after laparoscopic fundoplication. Chest. 2005;128:2458–64.

    Article  PubMed  Google Scholar 

  27. Ebihara S, Ebihara T, Yamasaki M, Asada M, Yamanda S, Niu K, et al. Contribution of gastric acid in elderly nursing home patients with cough reflex hypersensitivity. J Am Geriatr Soc. 2007;55:1686–8.

    Article  PubMed  Google Scholar 

  28. Stein MR. Possible mechanisms of influence of esophageal acid on airway hyperesponsiveness. Am J Med. 2003;115(Suppl 3A):55S–9S.

    Article  CAS  PubMed  Google Scholar 

  29. Allen GB, Leclair TR, von Reyn J, Larrabee YC, Cloutier ME, Irvin CG, et al. Acid aspiration-induced airways hyperresponsiveness in mice. J Appl Physiol. 2009;107:1763–70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Herve P, Denjean A, Jian R, Simonneau G, Duroux P. Intraesophageal perfusion of acid increases the bronchomotor response to methacholine and to isocapnic hyperventilation in asthmatic subjects. Am Rev Respir Dis. 1986;134:986–9.

    Article  CAS  PubMed  Google Scholar 

  31. Chakrabarti S, Singh K, Singh V, Nain CK, Jindal SK. Airway response to acid instillation in esophagus in bronchial asthma. Indian J Gastroenterol. 1995;14:44–7.

    PubMed  CAS  Google Scholar 

  32. Wu DN, Tanifuji Y, Kobayashi H, Yamauchi K, Kato C, Suzuki K, et al. Effects of esophageal acid perfusion on airway hyperresponsiveness in patients with bronchial asthma. Chest. 2000;118(6):1553.

    Article  CAS  PubMed  Google Scholar 

  33. Dal Negro RW, Tognella S, Micheletto C, Sandri M, Guerriero M. A MCh test pre-post esophageal acidification in detecting GER-related asthma. J Asthma. 2009;46:351–5.

    Article  CAS  PubMed  Google Scholar 

  34. Vincent D, Cohen-Jonathan AM, Leport J, Merrouche M, Geronimi A, Pradalier A, et al. Gastro-oesophageal reflux prevalence and relationship with bronchial reactivity in asthma. Eur Respir J. 1997;10:2255–9.

    Article  CAS  PubMed  Google Scholar 

  35. Bagnato GF, Gulli S, Giacobbe O, De Pasquale R, Purello D’Ambrosio F. Bronchial hyperresponsiveness in subjects with gastroesophageal reflux. Respiration. 2000;67:507–9.

    Article  CAS  PubMed  Google Scholar 

  36. Moote DW, Lloyd DA, McCourtie DR, Wells GA. Increase in gastroesophageal reflux during methacholine-induced bronchospasm. J Allergy Clin Immunol. 1986;78:619–23.

    Article  CAS  PubMed  Google Scholar 

  37. Zerbib F, Guisset O, Lamouliatte H, Quinton A, Galmiche JP, Tunon-De-Lara JM. Effects of bronchial obstruction on lower esophageal sphincter motility and gastroesophageal reflux in patients with asthma. Am J Respir Crit Care Med. 2002;166:1206–11.

    Article  PubMed  Google Scholar 

  38. Ekstrom T, Tibbling L. Esophageal acid perfusion, airway function, and symptoms in asthmatic patients with marked bronchial hyperreactivity. Chest. 1989;96:995–8.

    Article  CAS  PubMed  Google Scholar 

  39. Singh V, Aggarwal V, Bansal S, Nijhawan S, Chaudhary N. Effect of intraesophageal acid instillation on airway reactivity in patients with asthma. J Assoc Physicians India. 2000;48:601–2.

    PubMed  CAS  Google Scholar 

  40. Agarwal A, Rishi JP, Gupta AN, Bhandari VM. Histamine bronchoprovocation tests in subjects with gastro-oesophageal reflux disease. J Assoc Physicians India. 1990;38:159–61.

    PubMed  CAS  Google Scholar 

  41. Compte L, Garrigues V, Perpina M, Ponce J. Prevalence of gastroesophageal reflux in asthma. J Asthma. 2000;37:175–82.

    Article  CAS  PubMed  Google Scholar 

  42. DiMango E, Holbrook JT, Simpson E, Reibman J, Richter J, Narula S, et al. Effects of asymptomatic proximal and distal gastroesophageal reflux on asthma severity. Am J Respir Crit Care Med. 2009;180:809–16.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Emilsson OI, Bengtsson A, Franklin KA, Toren K, Benediktsdottir B, Farkhoov A, et al. Nocturnal gastro-oesophageal reflux, asthma and symptoms of OSA: a longitudinal, general population study. Eur Respir J. 2013;41:1347–54.

    Article  PubMed  Google Scholar 

  44. Jiang SP, Liang RY, Zeng ZY, Liu QL, Liang YK, Li JG. Effects of antireflux treatment on bronchial hyper-responsiveness and lung function in asthmatic patients with gastroesophageal reflux disease. World J Gastroenterol. 2003;9(5):1123.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Sato A, Tanifuji Y, Kobayashi H, Inoue H. Effects of proton pump inhibitor on airway hyperresponsiveness in asthmatics with gastroesophageal reflux. Arerugi. 2006;55:641–6.

    PubMed  Google Scholar 

  46. Khoshoo V, Mohnot S, Haydel R, Saturno E, Edell D, Kobernick A. Bronchial hyperreactivity in non-atopic children with asthma and reflux: effect of anti-reflux treatment. Pediatr Pulmonol. 2009;44:1070–4.

    Article  PubMed  Google Scholar 

  47. Kiljander TO, Salomaa ER, Hietanen EK, Ovaska J, Helenius H, Liippo K. Gastroesophageal reflux and bronchial responsiveness: correlation and the effect of fundoplication. Respiration. 2002;69:434–9.

    Article  PubMed  Google Scholar 

  48. Karbasi A, Ardestani ME, Ghanei M, Harandi AA. The association between reflux esophagitis and airway hyper-reactivity in patients with gastro-esophageal reflux. J Res Med Sci. 2013;18:473–6.

    PubMed  PubMed Central  Google Scholar 

  49. Boeree MJ, Peters FT, Postma DS, Kleibeuker JH. No effects of high-dose omeprazole in patients with severe airway hyperesponsiveness and (a)symptomatic gstro-oesophageal reflux. Eur Respir J. 1998;11:1070–4.

    Article  CAS  PubMed  Google Scholar 

  50. Kiljander T, Rantanen T, Kellokumpu I, Koobi T, Lammi L, Nieminen M, et al. Comparison of the effects of esomeprazole and fundoplication on airway responsiveness in patients with gastro-oesophageal reflux disease. Clin Respir J. 2013;7:281–7.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA

    Peter V. Dicpinigaitis

Authors
  1. Peter V. Dicpinigaitis
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. University of Hull, Hull York Medical School, Cottingham, East Yorkshire, United Kingdom

    Alyn H. Morice

  2. Castle Hill Hospital, RD Biomed Limited, Cottingham, East Yorkshire, United Kingdom

    Peter W. Dettmar

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Dicpinigaitis, P.V. (2018). Effect of Reflux on Cough Sensitivity and Bronchial Responsiveness. In: Morice, A., Dettmar, P. (eds) Reflux Aspiration and Lung Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-90525-9_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-90525-9_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-90523-5

  • Online ISBN: 978-3-319-90525-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation