In this issue of CHEST (see page 679), Poe and Kallay report on a practical approach for diagnosing and treating GER-related cough that was successfully utilized in their pulmonary specialty practice affiliated with a university. Using the anatomic diagnostic protocol in 214 patients, with cough resolution defining success, GER-related cough was present in 53 subjects (31%). As in previously reported trials, clinically silent GER was present in 24 of their subjects (43%). Another key finding is that an empiric trial of antireflux therapy successfully diagnosed and treated GER-related cough in 42 patients (79%). All of their GER subjects were instructed on lifestyle measures (ie, weight reduction, high-protein antireflux diet, and elevation of head of bed) and were prescribed omeprazole, 40 mg, lansoprazole, 30 mg, or rabeprazole, 20 mg, to take each morning before breakfast. A prokinetic agent was added to the regimen if dysphagia was present or if initial therapy with a proton pump inhibitor was less successful than expected (18 subjects). If the empiric trial approach failed, then 24-h esophageal pH testing was employed in the nonresponders (12 subjects). Of these initial nonresponders, four eventually responded to therapy with high-dose proton pump inhibitors combined with a prokinetic agent, and two had success with surgical fundoplication. Poe and Kallay also noted that 4 weeks of therapy resulted in cough resolution in 86% of their responders, while 6 weeks of therapy resulted in cough resolution in 95% of their responders.