Immediate relief for acid reflux cough
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Immediate Relief for Acid Reflux Cough
Understanding Acid Reflux Cough
Gastroesophageal Reflux Disease (GERD) and Chronic Cough
Gastroesophageal reflux disease (GERD) is a common condition where stomach acid frequently flows back into the esophagus, leading to symptoms such as heartburn and acid regurgitation. Chronic cough, defined as a cough lasting more than eight weeks, is often associated with GERD. This condition can cause laryngopharyngeal reflux, where the refluxate reaches the pharynx, larynx, or pulmonary system, provoking symptoms like throat discomfort, hoarseness, and chronic cough1 4.
Acid-Suppressive Therapy for Immediate Relief
Proton Pump Inhibitors (PPIs)
Proton pump inhibitors (PPIs) are commonly used to suppress stomach acid production and are often prescribed for GERD-related chronic cough. Studies have shown that PPIs can significantly improve cough symptoms in patients with pathological esophageal acid exposure. However, the therapeutic gain varies, with a higher response rate in patients with confirmed acid reflux compared to those without1 4. For instance, esomeprazole, a type of PPI, has been shown to be effective in reducing chronic cough symptoms in some patients3.
Ranitidine
Ranitidine, an H2 receptor antagonist, has also been used in the treatment of GERD-related chronic cough. Although less commonly prescribed than PPIs, it has shown some efficacy in reducing cough symptoms in certain patient populations1.
Alternative Treatments for Refractory Cases
Baclofen
For patients whose chronic cough is unresponsive to standard acid-suppressive therapy, baclofen, a GABA(B) receptor agonist, may be considered. Baclofen has been shown to reduce the frequency of reflux episodes and improve cough symptoms in patients with refractory GERD-induced chronic cough. In a study, 56.3% of patients experienced improvement in their cough symptoms with baclofen treatment, although it is associated with side effects such as somnolence, dizziness, and fatigue5.
Conclusion
Immediate relief for acid reflux cough can often be achieved through the use of acid-suppressive therapies such as PPIs and, to a lesser extent, ranitidine. For patients with refractory symptoms, baclofen may offer an alternative treatment option. However, the effectiveness of these treatments can vary, and patient selection based on objective evidence of GERD is crucial for optimal outcomes. Further research is needed to refine treatment strategies and improve symptom relief for all patients suffering from GERD-related chronic cough.
Sources and full results
Most relevant research papers on this topic
Response of chronic cough to acid-suppressive therapy in patients with gastroesophageal reflux disease.
Acid-suppressive therapy shows a therapeutic benefit for chronic cough patients, but rigorous patient selection is necessary to identify responsive populations.
Systematic Review
Highly CitedBeyond heartburn: a systematic review of the extra-oesophageal spectrum of reflux-induced disease.
Gastro-oesophageal reflux disease (GORD) may cause chest pain, asthma, chronic cough, and laryngitis, and acid-suppressive therapy may provide relief for these symptoms.
Systematic ReviewChronic cough and esomeprazole: A double‐blind placebo‐controlled parallel study
Esomeprazole, a proton pump inhibitor, effectively reduces chronic cough in patients with gastro-oesophageal reflux compared to placebo.
RCTHighly CitedShould Acid Suppressive Therapy Improve Chronic Cough? (Chest 2013;143:605-612)
Acid suppressive therapy may provide a therapeutic benefit for chronic cough in patients with GERD, particularly in those with pathologic esophageal acid exposure.
Systematic Review
Rigorous JournalTherapeutic efficacy of baclofen in refractory gastroesophageal reflux-induced chronic cough.
Baclofen is a useful but suboptimal treatment option for refractory gastroesophageal reflux-induced chronic cough, improving symptoms in 56.3% of patients and reducing acid reflux episodes.
Non-RCTRigorous JournalCough threshold in reflux oesophagitis: influence of acid and of laryngeal and oesophageal damage
Reflux oesophagitis patients have a decreased cough threshold, influenced by laryngeal inflammation and acid flooding, and omeprazole improves both respiratory and gastro-oesophageal symptoms.
Observational StudyHighly CitedChronic cough due to gastroesophageal reflux disease: failure to resolve despite total/near-total elimination of esophageal acid.
Antireflux surgery can improve chronic cough due to GERD resistant to intensive medical therapy, and the term acid reflux disease may be a misnomer.
Non-RCTHighly CitedReflux and cough.
Reflux contributes to cough by direct irritation and increasing sensitivities to other noxious agents, and treatment focuses on dietary changes, lifestyle changes, and medication.
Chronic cough due to gastroesophageal reflux disease: ACCP evidence-based clinical practice guidelines.
Chronic cough due to GERD can be accurately diagnosed and successfully treated with antireflux medical therapy, but objective investigation is recommended when empiric treatment fails.
Systematic ReviewHighly CitedGastro-oesophageal reflux treatment for prolonged non-specific cough in children and adults.
PPI is not efficacious for chronic non-specific cough in very young children and should not be used for cough outcomes, while in adults, there is no significant improvement in overall cough outcomes.
Meta-Analysis
Very Rigorous JournalHighly Cited