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Education, Teaching, and Quality Improvement |

Challenges of Chronic Cough Caused by Gastroesophageal Reflux Disease in Clincal Management FREE TO VIEW

Doina Todea; Loredana Elena Rosca; Andreea Codruta Coman
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University of Medicine and Pharmacy Iuliu Hatieganu Cluj-Napoc, Romania, Cluj-Napoca, Romania


Chest. 2014;146(4_MeetingAbstracts):531A. doi:10.1378/chest.1992318
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Abstract

SESSION TITLE: Quality & Clinical Improvement Posters I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: One of most common cause of chronic cough have traditionally been gastroesophageal reflux disease (GERD), known as gastroesophageal reflux induced cough (GERC). However GERD is a common cause of chronic cough and occurs in approximately 5-41% of cases of chronic cough. The purpose of this study was to assess the relation between chronic cough and GERD, to evaluate the response of respiratory symptoms after 8 weeks of medical intervention with acid suppressive therapy, and also to evaluate the quality of life before and after treatment using Cough Specific Quality of Life Questionnaire (CQLQ).

METHODS: 66 consecutive patients from January 2013 to January 2014, nonsmokers, with chronic cough undiagnosed at least 8 weeks and with clinical symptoms specific for GERD (heartburn and regurgitations) were prospectively recruited into the study. They were assessed clinical and paraclinical (history, physical examination, CQLQ questionnaire, chest radiography, spirometry, skin prick tests to common allergens and gastro-esophageal endoscopy). After that we establish a clinical diagnosis and the patient had an 8-week trial of appropriate therapy with proton pump inhibitors ( Omeprazole 20 mg o.d.) and prokinetic agents (Metoclopramide 30 mg tid).

RESULTS: In 49/66 (74.24%) cases gastro-esophageal reflux preceded respiratory symptoms. After treatment period 50 patients (75.75%) were classified as responders (improvement of cough), in 16 cases (24.24%) respiratory symptoms persist unchanged, none of patients had aggravation of cough. After supplementary investigations there was find a final diagnosis in non responders patients. There was a significant statistic corelation (p<0.001) for HRQL using CQLQ after medical therapy, with improvement of HRQL after therapy.

CONCLUSIONS: In conclusion, GERD is a common disorder related with chronic cough. Accurately diagnosing and successfully treating chronic cough due to GERD can be a major challenge in the management of chronic cough.

CLINICAL IMPLICATIONS: GERC requiring early recognition and treatment in order to increase the quality of life of the patients with GERC.

DISCLOSURE: The following authors have nothing to disclose: Doina Todea, Loredana Elena Rosca, Andreea Codruta Coman

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