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Weak peristalsis with large breaks in chronic cough: association with poor esophageal clearance
Background Gastroesophageal reflux plays an important role in chronic cough (CC). Whether disturbed esophageal motility contributes to increased esophageal reflux exposure or interferes with swallowed bolus clearance is unclear. This study used high resolution esophageal manometry and impedance (HRI...
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Published in: | Neurogastroenterology and motility 2015-03, Vol.27 (3), p.431-442 |
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Main Authors: | , , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
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Summary: | Background
Gastroesophageal reflux plays an important role in chronic cough (CC). Whether disturbed esophageal motility contributes to increased esophageal reflux exposure or interferes with swallowed bolus clearance is unclear. This study used high resolution esophageal manometry and impedance (HRIM) together with Chicago Classification, and 24‐h impedance pH (MII/pH) to address these questions in patients with CC compared with heartburn (HB).
Methods
A retrospective review of 32 patients with CC (mean age 57 [95% CI: 52–62] years) and 32 patients with symptoms of HB (55 [52–62] years) referred for HRIM and MII/pH between September 2012 and September 2013 was undertaken.
Key Results
Weak peristalsis with large breaks (WPLBs) was observed in 34% of CC patients compared with only 12% of HB patients (p = 0.027). Pathological acid exposure time (AET) was identified in 81% of CC patients with WPLBs compared with 29% without (p = 0.011). Increased AET was associated with prolonged clearance time of refluxed events (p = 0.006) rather than increased number of events. AET correlated with the percentage of peristaltic events with large breaks in CC (ρ = 0.467, p = 0.007). Similar data were obtained for total bolus (acid and non‐acid) exposure time. Only one of the CC patients with WPLBs exhibited complete bolus transit (CBT) on swallowing compared with 81% without WPLBs (p |
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ISSN: | 1350-1925 1365-2982 |
DOI: | 10.1111/nmo.12513 |