Factors associated with treatment response in gastroesophageal reflux- related chronic cough

Although gastroesophageal reflux (GER) is a common cause of chronic cough, treatment efficacy of GER-related cough is often perceived unsatisfactory. Aim: to analyze the factors associated with the efficacy of treatment of chronic cough related to GER. A retrospective analysis of the clinical data of patients with cough due to GER was performed. GER was confirmed by either 24 hour esophageal pH measurement or combined impedance and pH monitoring. Modification of diet and PPI were recommended as treatment. Response to therapy was assessed by telephone survey, 6 weeks after onset of treatment. The patient was classified as a responder (R), if he/she declared a decrease in cough intensity at least of 50%, otherwise the patient was considered a non-responder (NR). The comparison between R and NR was accomplished using Mann-Whitney U or chi square tests. GER was confirmed in 37 of 80 patients diagnosed because of chronic cough. Complete data of 25 patients were available for analysis (median age 60 yrs, 13F, 12M, median BMI 29 kg/m2, median cough intensity 74/100 mm measured by VAS). Thirteen (52%) patients declared a positive response to therapy, while 12 were NR. There were no differences between R and NR in age, gender, BMI, cough severity, coexisting asthma or upper airway cough syndrome. The duration of cough was shorter in R than NR (24 vs 84 months, p=0.036). Typical symptoms of GER were more frequent in R (p=0.026). The two groups did not differ in terms of intraluminal pH and impedance parameters. Subjective response to PPI therapy was observed in 52% of patients with chronic cough related to GER. Shorter cough duration and presence of typical GER symptoms response to treatment.