Management of gastroesophageal reflux disease-related chronic cough

In patients with chronic cough who are systematically evaluated the cause is one or more of postnasal drip syndrome, cough-variant asthma, or gastroesophageal reflux disease (GERD) in 90% (1,2). There have been major advances in the diagnosis and management of GERD in recent years and there is now consensus in the management of many aspects of this very common condition (3-5). The management of patients with cough due to GERD, however, remains a challenging problem requiring an understanding of management of both cough and gastroesophageal reflux. The more difficult patients are best managed by a multidisciplinary team with a pulmon ary physician, a gastroenterologist, and an experienced esophageal surgeon capable of performing laparoscopic surgery. This chapter will present an overview of the current approach to the diagnosis and management of GERD based on recent consensus documents and systematic overviews, discuss the currently available literature regarding the treatment of gastroesophageal reflux in patients with chronic cough, and finally present a practical approach to the assessment and treatment of these patients.