Tag: microaspiration (Page 2)

Chronic Cough Due to Gastroesophageal Reflux Disease: Treatment

For patients with chronic cough, the following tests are not routinely recommended to link cough with GERD: (a) assessing for lipidladen macrophages in BAL fluid and induced sputum, because this test has not been studied in patients with chronic cough and because a positive test result is not specific for aspiration; (b) exhaled nitric oxide […]

Chronic Cough Due to Gastroesophageal Reflux Disease: Levels

In patients with chronic cough being evaluated for GERD, the 24-h esophageal pH-mon-itoring test is the most sensitive and specific test; however, it is recommended that the test results be interpreted as normal only when conventional indexes for acid reflux are within the normal range and no reflux-induced coughs appear during the monitoring study. Level […]

Chronic Cough Due to Gastroesophageal Reflux Disease: Possible Cause

On the basis of the above considerations, the panel recommends that an empiric trial of medical antireflux therapy be performed in patients who meet the clinical profile (Table 1) predicting that silent GERD is the likely cause of chronic cough or in patients with chronic cough who also have prominent upper GI symptoms (eg, heartburn, […]

Chronic Cough Due to Gastroesophageal Reflux Disease: Surgery

Irwin et al, in a small, prospective, before-and-after intervention trial in patients with chronic cough who had failed to respond to very intensive medical therapy, reported the improvement or elimination of cough in all subjects 12 months following surgery. In this study, cough persisted prior to surgery even though the antireflux medical regimen was serially […]

Chronic Cough Due to Gastroesophageal Reflux Disease: Empiric Trial of Therapy

The first consensus panel report in 1998 recommended that, when 24-h esophageal pH monitoring cannot be performed or is not available, a diagnostic, empiric trial of medical antireflux therapy be performed in patients who meet the clinical profile (Table 1) predicting that silent GERD is the likely cause of chronic cough or in patients with […]

Chronic Cough Due to Gastroesophageal Reflux Disease: GERD

A post hoc analysis of the data revealed that observing few or no lipid-laden alveolar macrophages might be helpful in ruling out aspiration as the cause of the parenchymal lung disease. This conclusion was reached on the basis of the following information: a lipid cellular index of > 100, which was computed by multiplying the […]

Chronic Cough Due to Gastroesophageal Reflux Disease: Results

While impedance monitoring allows for the detection of air and liquid reflux without requiring a pH shift to detect the liquid reflux, the simultaneous monitoring of pH helps to determine whether the liquid reflux observed by impedance was acidic in nature. Dual-impedance pH monitoring may also help to determine the roles of esophageal manometry in […]