%0 Journal Article
%T Fundoplication in chronic intractable cough
%A Shoaib Faruqi
%A Peter Sedman
%A Warren Jackson
%A Ian Molyneux
%A Alyn H Morice
%J Cough
%D 2012
%I BioMed Central
%R 10.1186/1745-9974-8-3
%X We retrospectively reviewed the case notes of patients from the Hull Cough Clinic who had undergone Nissen fundoplication over the past 6£¿years. Demographic details, duration of symptoms, presence of other symptoms, results of oesophageal studies, outcome and complications were recorded. Patients were contacted by post and asked to complete a questionnaire detailing current symptoms. In a subgroup with continued troublesome cough 24 hour pharyngeal pH measurements were undertaken.Forty seven patients underwent fundoplication. The average duration of pre-operative cough was 8£¿years. Gastro intestinal symptoms were present in the majority. In 30 (64%) patients a positive response to treatment was recorded. Mild dysphagia or bloating was seen in 18 patients following surgery. Four patients needed repeat surgical intervention for modification of fundoplication. One patient developed aspiration pneumonia eight weeks following surgery and died of a myocardial infarction. Two thirds of patients with persisting cough had evidence of airway reflux on pharyngeal pH monitoring.In these patients with intractable cough a long term response rate of 63% represents a useful therapeutic option. Treatment failure is more frequent than for classic peptic symptoms and may be related to persistent gaseous reflux.In a number of prospective series gastro-oesophageal reflux disease (GORD) has been demonstrated to be associated with chronic cough. This association has led to the implication that GORD is a causal factor in its pathogenesis. However, classical GORD symptoms of ¡°heart burn¡± and ¡°dyspepsia¡± are often absent in patients with other manifestations of airway reflux. Non or weakly acid reflux has also been implicated in the genesis of chronic cough. This suggests that the reflux causing cough is unlike that causing GORD and may be non acidic or even gaseous in nature. Whilst anti-acid medications are effective in treating the classical peptic symptoms of GORD and an empirical therap
%K Chronic cough
%K Reflux
%K Fundoplication
%U http://www.coughjournal.com/content/8/1/3