title: Gastroesophageal reflux as a cause of chronic cough, severe asthma, and migratory pulmonary infiltrates.
abstract: Gastroesophageal reflux (GER), asthma-type cough and upper airway disease are the most common causes of chronic cough syndrome. We present a case in which impedance-pH monitoring indicated severe mixed acid-nonacid esophageal reflux reaching the upper third of the esophagus in 75% of nonacid events. GER and the associated aspiration episodes were shown to be the cause of severe asthma attacks and migratory pulmonary infiltrates. GER was caused by a sleeve gastrectomy, which seriously disabled the mechanisms preventing reflux from reaching the airways. Respiratory symptoms improved notably after abdominal surgery to correct the GER, suggesting a close causal relationship between GER and all the symptoms, including asthma. However, this issue remains unresolved in the literature.
authors.affiliation: Pneumology Department, Chronic Cough Unit, Hospital Ramón y Cajal Madrid, Spain.
authors.forename: Paula
authors.initials: P
authors.lastname: Ribó
authors.affiliation: Pneumology Department, Chronic Cough Unit, Hospital Ramón y Cajal Madrid, Spain.
authors.forename: Adalberto
authors.initials: A
authors.lastname: Pacheco
authors.affiliation: Pneumology Department, Chronic Cough Unit, Hospital Ramón y Cajal Madrid, Spain.
authors.forename: Paola
authors.initials: P
authors.lastname: Arrieta
authors.affiliation: Digestive Motility Unit, Hospital Ramón y Cajal Madrid, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Teruel
authors.affiliation: Otolaryngology Department, Hospital Ramón y Cajal Madrid, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Cobeta
keywords: Asthma; chronic cough; migratory pulmonary infiltrates