title: Refractory chronic cough due to gastroesophageal reflux: Definition, mechanism and management.
abstract: Refractory chronic cough due to gastroesophageal reflux is a troublesome condition unresponsive to the standard medical anti-reflux therapy. Its underlying mechanisms may include incomplete acid suppression, non-acid reflux, transient lower esophageal sphincter relaxations and esophageal hypersensitivity. The diagnosis of this disorder depends on both the findings of multi-channel intraluminal impedance-pH monitoring and the subsequent intensified anti-reflux therapy. The strategies of pharmacological treatment for refractory chronic cough due to reflux include the optimization of proton pump inhibitors and add-on therapies with histamine H2 receptor antagonists, baclofen and gabapentin. However, the further study is needed to satisfy its management.
authors.affiliation: Han-Jing Lv, Zhong-Min Qiu, Department of Respiratory Medicine, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China.
authors.forename: Han-Jing
authors.initials: HJ
authors.lastname: Lv
authors.affiliation: Han-Jing Lv, Zhong-Min Qiu, Department of Respiratory Medicine, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China.
authors.forename: Zhong-Min
authors.initials: ZM
authors.lastname: Qiu
keywords: Anti-reflux therapy; Chronic cough; Esophageal pH monitoring; Gastroesophageal reflux; Refractory cough