Clinical impact of gastroesophageal reflux disease in patients with subacute/chronic cough.
BACKGROUND
While gastroesophageal reflux disease (GERD) is one of the commonest causes of subacute/chronic cough along with cough-variant asthma (CVA) and rhinosinusitis, its clinical impact remains unknown. Therefore, we sought to investigate the impact of GERD in patients with subacute/chronic cough.


METHODS
Between April 2012 and March 2018, a total of 312 patients presenting subacute or chronic cough lasting for ≥3 weeks [median cough duration, 4.9 (0.7-434) months] underwent diagnostic tests. GERD symptoms and cough-specific QoL were evaluated through the Frequency Scale for Symptoms of Gastroesophageal reflux (FSSG) and the Japanese version of the Leicester Cough Questionnaire (J-LCQ). According to the FSSG domains, patients with GERD were arbitrarily categorized into 3 groups; acid-reflux predominant, dysmotility predominant, and pauci-symptoms groups, respectively.


RESULTS
The average scores of J-LCQ was 12.5 (SD3.7). One hundred-forty three were diagnosed as having GERD-related cough based on classical reflux symptoms including heartburn and characteristic triggers of cough such as phonation, rinsing, lying, and eating. Most of them (89.8%) had other causative diseases including CVA. Cough lasted longer (p = 0.019) and required a longer time until alleviation (p = 0.003) in patients with GERD than in those without GERD. They also scored lower J-LCQ than counterpart group (p < 0.0001). In terms of symptom stratification, dysmotility predominant group showed significant more response to specific GERD treatments than the remnants (p = 0.002).


CONCLUSIONS
These results indicate that GERD is associated with the aggravation of other causes including CVA. Particularly, dysmotility symptoms may be potential therapeutic target for GERD-related cough.
['Kanemitsu|Yoshihiro|Y|', 'Kurokawa|Ryota|R|', 'Takeda|Norihisa|N|', 'Takemura|Masaya|M|', 'Fukumitsu|Kensuke|K|', 'Asano|Takamitsu|T|', 'Yap|Jennifer|J|', 'Suzuki|Motohiko|M|', 'Fukuda|Satoshi|S|', 'Ohkubo|Hirotsugu|H|', 'Maeno|Ken|K|', 'Ito|Yutaka|Y|', 'Oguri|Tetsuya|T|', 'Niimi|Akio|A|']
D000328:Adult D000368:Aged D002908:Chronic Disease D003371:Cough D005260:Female D005764:Gastroesophageal Reflux D006801:Humans D008297:Male D008875:Middle Aged D062486:Public Health Surveillance D011788:Quality of Life D012129:Respiratory Function Tests D012189:Retrospective Studies D012720:Severity of Illness Index D011795:Surveys and Questionnaires
Gastroesophageal reflux disease Subacute/chronic cough GERD symptoms Cough-specific quality of life Prokinetic agents