RT Journal Article
SR Electronic
T1 Oesophageal pH monitoring is of limited value in the diagnosis of “reflux-cough”
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 724
OP 727
DO 10.1183/09031936.04.00007404
VO 24
IS 5
A1 R.N. Patterson
A1 B.T. Johnston
A1 J. MacMahon
A1 L.G. Heaney
A1 L.P.A. McGarvey
YR 2004
UL http://erj.ersjournals.com/content/24/5/724.abstract
AB Reflux-cough is a diagnosis based on demonstrating both gastro-oesophageal reflux and a positive response to anti-reflux therapy. The authors sought to determine early and long-term response to therapy in patients with a “positive” 24 h oesophageal pH study, and identify any features which might predict response. Patients with chronic cough were recruited from July 1998 to July 2002. Those with a positive pH study were given dietary advice and an 8-week trial of omeprazole (20 mg b.i.d.). Response was judged after 8 weeks (clinical follow-up), and at long-term follow-up (telephone questionnaire). A total of 146 patients underwent pH monitoring with 82 (56.2%) “positive” studies. Follow-up data was available in 60 patients, with 49 receiving anti-reflux therapy, of which 20 (40.8%) reported a positive treatment response. At long-term follow-up (median 30 months), there was a significantly lower response (14 out of 49, 28.5%), with no significant difference in either acid exposure times (distal/proximal) or symptom correlation between responders and nonresponders at early or long-term follow-up. In conclusion, despite “positive” pH studies, over half of the patients (55.1%) failed torespond to therapy. No features on pH monitoring accurately predicted response. Short-term response did not predict long-term response. The precise role for pH monitoring in the assessment of chronic cough remains to be defined.