КАШЕЛЬ И ГАСТРОЭЗОФАГЕАЛЬНЫЙ РЕФЛЮКС: НЕПРОСТЫЕ ВЗАИМОДЕЙСТВИЯ (ЧАСТЬ 2)

Abstract

For many decades, researchers have been interested in the problem of the relationship between cough and gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD). The question has not only theoretical, but also practical significance, since it determines the diagnostic and therapeutic, both for coughing and for GER, while uniting under their «banners» specialists of various profiles: physicians, pediatricians, gastroenterologists, pulmonologists and others. This article presents and discusses the data of domestic and international publications on this issue and, based on current knowledge, the concept of the relationship between GER, GERD and cough, including bronchoobstructive syndrome in bronchial asthma, is proposed, as well as recommendations for practical work of doctors in this clinical situation. Based on the available data, it can be argued that the relationship between GER (GERD) and cough is obvious, but many details of this interaction remain poorly understood. It should be noted the important role played by a hiatal hernia (HH) both in the development of GER and the cough associated with it. Children with chronic cough that do not respond to basic therapy are shown to be examined in order to identify the possible effect of GER on its formation. In this regard, it is important to identify HH in order to determine the tactics of patient management and resolve the issue of its surgical correction. On the other hand, patients with GERD are shown at least a minimal examination to clarify the state of the respiratory system, even in the absence of obvious respiratory symptoms.