In children and adults with nonspecific cough, is treatment for gastroesophageal reflux effective in decreasing cough?
Bottom Line:
Treatment for gastroesophageal reflux disease (GERD) in patients with chronic cough may be effective in some patients, but the effect is not universal or consistent. It might be worth a try, but don't expect many patients to improve.
Use of a proton pump inhibitor to treat cough associated with GORD has some effect in some adults. The effect, however, is less universal than suggested in consensus guidelines on chronic cough and its magnitude of effect is uncertain.
Reference:
Chang AB, Lasserson TJ, Kiljander TO, Connor FL, Gaffney JT, Garske LA. Systematic review and meta-analysis of randomised controlled trials of gastro-oesophageal reflux interventions for chronic cough associated with gastro-oesophageal reflux. BMJ 2006;332:11-14.
Study Design:
Meta-analysis (randomized controlled trials)
Synopsis:
For this meta-analysis, the researchers searched MEDLINE, the Cochrane Controlled Trials Registry, and EMBASE for research evaluating treatment of GERD in patients with cough lasting at least 3 weeks. They also searched the references of articles and contacted authors. Two reviewers independently reviewed the literature searches and selected the 11 studies included in this review. This approach to chronic cough has only been studied in 338 patients, and, for some results, the number of patients is small.
Two studies in children found some improvement in GERD symptoms but did not find a consistent effect on cough. The study results could not be combined for meta-analysis. In adults, only 3 studies, enrolling a total of 49 patients, evaluated the presence of cough at the end of the trial. None of these studies found a benefit, and there was not a significant benefit when the studies were combined. Cough scores in other studies also were not consistently improved with proton pump inhibitors; 2 studies of omeprazole, when combined, showed a small but significant improvement in cough scores, whereas 2 studies of other proton pump inhibitors failed to find an improvement. Two crossover studies, in which each patient received placebo and then active treatment, showed a significant improvement in cough scores during treatment, but the 2 studies only included 35 patients.
