Nobata Kouichi, Asanoi Hidetsugu
The Department of Internal Medicine, Imizu City Hospital, Imizu, JapanAbstract.
J Med Case Rep. 2007 Aug 25;1:69. doi: 10.1186/1752-1947-1-69.
Because 24-h esophageal pH monitoring is quite invasive, the diagnosis of gastroesophageal reflux disease (GERD)-associated cough has usually been made based merely on the clinical efficacy of treatment with proton pump inhibitor (PPI).
We recently encountered two patients with PPI-responsive chronic non-productive cough for whom switching from bronchodilators and glucocorticosteroids to PPI resulted in improvement of cough. The cough returned nearly to pre-administration level a few weeks after discontinuation of PPI. Though GERD-associated cough was suspected, 24-h esophageal pH monitoring revealed that the cough rarely involved gastric acid reflux. Following re-initiation of PPI, the cough disappeared again.
PPI may improve cough unrelated to gastric acid reflux.
由于24小时食管pH监测具有较强的侵入性,胃食管反流病(GERD)相关咳嗽的诊断通常仅基于质子泵抑制剂(PPI)治疗的临床疗效。
我们最近遇到两名对PPI有反应的慢性干咳患者,他们从支气管扩张剂和糖皮质激素改用PPI后咳嗽得到改善。停用PPI几周后,咳嗽几乎恢复到用药前水平。尽管怀疑是GERD相关咳嗽,但24小时食管pH监测显示咳嗽很少涉及胃酸反流。重新开始使用PPI后,咳嗽再次消失。
PPI可能改善与胃酸反流无关的咳嗽。