Abstract
BackgroundChronic cough is a common and distressing symptom. Gastro-oesophageal reflux is a common cause of chronic cough however the symptom complex in cough is not confined to classic peptic symptoms. Dyspeptic symptoms have previously been shown to respond to dietary modifications and weight loss. We hypothesised that weight reduction maybe a useful non-pharmacological strategy in reducing reflux cough in the obese.MethodsSubjects with cough were recruited from Hull Cough Clinic. They were randomised to one of two open parallel groups; one receiving the traditional dietary modifications and the other weight reduction advice in the form of an Energy Prescription (EP). Cough symptoms, using the Leicester cough questionnaire (LCQ) and dietary intake were measured at the start and end of the study.ResultsThirty-three patients were recruited and 20 patients completed the study. Mean weight loss was 3.1 kg (p < 0.001) and reported an improvement in the LCQ (mean improvement 3.1); which is greater than the clinically significant score of 1.3. . Moreover, secondary outcomes showed a significant association between baseline high calorie (r = -0.24; p < 0.001) and fat intake (r = -0.36; p = 0.001), and LCQ scores.ConclusionA high calorie and fat intake is strongly correlated with cough score. Irrespective of diet, weight loss is associated with a reduction in cough symptoms. Asking patients to lose weight by reducing fat and calorie intake may be a simple strategy to ameliorate this intractable condition.Trial RegistrationThe study was approved by the local research ethics committee (South Humber Local Research Ethics Committee; REC04/Q1105/62). The study was registered with the Research and Development Department, Clinical Governance Directorate, Hull and East Yorkshire Hospitals NHS Trust (reference number R0086).
Highlights
Chronic cough is a common and distressing symptom
We have recently demonstrated an association of a chronic cough with obesity [10] and have observed in clinical practice that weight gain can be associated with the onset of chronic cough
We found that weight reduction, irrespective of diet reduced cough reflux symptoms and this has not been found before
Summary
Chronic cough is a common and distressing symptom. Gastro-oesophageal reflux is a common cause of chronic cough the symptom complex in cough is not confined to classic peptic symptoms. We hypothesised that weight reduction maybe a useful non-pharmacological strategy in reducing reflux cough in the obese. Gastro-oesophageal reflux is a common cause of chronic cough [4]. A number of studies have reported a higher incidence of classic acid related reflux symptoms (gastro-oesophageal reflux disease (GORD)) in overweight and obese people [5,6,7,8]. In a systematic review of 16 studies of GORD management, weight loss was associated with improved oesophageal pH profiles and GORD related symptoms [9]. The effect of weight loss on cough has not been studied
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