| CHRONIC COUGH: RELATIONSHIP BETWEEN MICRO-ASPIRATION, GASTROESOPHAGEAL REFLUX AND COUGH FREQUENCY. | |
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MedLine Citation:
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PMID: 22797535 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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ABSTRACT BACKGROUND: Micro-aspiration is often considered a potential cause of cough. The aim of this study was to investigate the relationship between micro-aspiration, the degree and type of gastro-oesophageal reflux, and the frequency of coughing in patients with chronic cough. METHODS: 100 chronic cough patients [mean age 55.8yrs (±11.0); 65 females] and 32 healthy volunteers [median age 43.5yrs(IQR 30-50.8); 16 females] were recruited. Chronic cough patients performed 24-hour objective cough frequency with simultaneous oesophageal impedance/pH monitoring and measurement of pepsin concentrations in sputum and bronchoalveolar lavage (BAL). 12 healthy volunteers underwent bronchoscopy/ BAL and 20 impedance/pH monitoring. RESULTS: Chronic cough patients had significantly more reflux episodes than healthy volunteers [median 63.5 reflux episodes (IQR 52.5-80.0) versus 59.0 (IQR 41.8-66.0), p=0.03] although the absolute difference was small, and there was no difference in numbers of events extending into the proximal oesophagus [median 17.2% (IQR 8.0-26.0%) versus 20.3% (IQR 5.1-32.1%), (p=0.36)]. BAL pepsin levels were also similar in chronic cough to controls subjects [median 18.2ng/ml (range 0-56.4) versus 9.25ng/ml (0-46.9), p=0.27]. Sputum but not BAL pepsin weakly correlated with the number of proximally occurring reflux events (r=0.33; p=0.045), but was inversely related to cough frequency (r=-0.52, p=0.04). Sputum pepsin was therefore best predicted by combining the opposing influences of cough and proximal reflux (r=0.50, p=0.004). CONCLUSIONS: Proximal gastro-oesophageal reflux and micro-aspiration into the airways have limited roles in provoking chronic cough. Indeed, coughing appears to be protective reducing pepsin concentration in the larger airways of patients with chronic cough. |
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Authors:
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Samantha Decalmer; Rachel Stovold; Lesley A Houghton; Jeff Pearson; Chris Ward; Angela Kelsall; Helen Jones; Kevin McGuinness; Ashley Woodcock; Jaclyn A Smith |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-7-10 |
Journal Detail:
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Title: Chest Volume: - ISSN: 1931-3543 ISO Abbreviation: - Publication Date: 2012 Jul |
Date Detail:
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Created Date: 2012-7-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0231335 Medline TA: Chest Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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