Effects of anti-reflux surgery on chronic cough and asthma in patients with gastro-oesophageal reflux disease.
This two-group prospective study evaluated the effect of anti-reflux surgery (fundoplication) on 24 patients with severe gastro-oesophageal reflux disease (GORD) and concomitant asthma (n=13) or chronic cough (n=11). Twenty-four hour oesophageal pH monitoring and lung function tests (FEV1, FVC) were done before and within 1 year after anti-reflux surgery. A diary was kept by the patient during the 4-week period prior to surgery and during 4-week periods 6 and 12 months postoperatively, with daily monitoring of peak expiratory flow rate, respiratory and reflux symptoms and medication. In non-asthmatic patients, coughing was reduced by 47% and 80% during the day and night, respectively, 12 months after surgery (P < 0.01). Concomitant hoarseness and expectoration were also significantly reduced (P<0.05). No effect on lung function was seen. In patients with asthma, small, non-significant reductions in asthma symptom scores and consumption of rescue medication were seen. Twenty-two patients were completely free from their GORD symptoms after surgery. In conclusion, anti-reflux surgery in patients with GORD had a more favourable effect on concomitant cough than concomitant asthma.
Ekström
T
T
Department of Pulmonary Medicine, University Hospital, Linköping, Sweden.
Johansson
K E
KE
D000328:Adult; D000368:Aged; D001249:Asthma / Q000150:complications / Q000601:surgery*; D002908:Chronic Disease; D003371:Cough / Q000209:etiology / Q000601:surgery*; D005260:Female; D005541:Forced Expiratory Volume; D018662:Fundoplication; D005764:Gastroesophageal Reflux / Q000150:complications / Q000601:surgery*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D014797:Vital Capacity