Investigating the Prevalence of Oesophageal Dysmotility in Patients with Refractory Chronic Cough

Abstract

<b>Introduction:</b> The link between the gut and lung has been previously studied in relation to Chronic Cough (CC). Studies have largely focused on the role Gastro-oesophageal Reflux Disease (GORD) in the development of CC and the study of oesophageal motility has been largely neglected. <b>Aims and Objectives:</b> To investigate the link between CC and oesophageal function through the use of high-resolution oesophageal manometry (HROM) and how oesophageal function may relate to Hull Airways Reflux Questionnaire (HARQ) scores. <b>Methods:</b> Data were collected for all patients with a diagnosis of CC that were investigated using HROM between January 1st 2011 and December 1st 2021. HROM was used to assess oesophageal function. All patients were given a grade of oesophageal function as per the Chicago Classification. HARQ scores were taken from all patients. <b>Results:</b> 339 patients were included (Mean age= 57 [SD=13.2], 67% Females). Of all patients, 68% were found to have a degree of oesophageal dysmotility. 58% (n=196) of patients displayed ineffective oesophageal motility, 5% (n=18) demonstrated absent contractility, and 3% (n=11) were found to have oesophagogastric junction outlet obstruction. Mean HARQ scores were significantly higher in patients with oesophageal dysmotility (41.0 vs 35.9, p=0.003). Of those who underwent 24-hour pH testing, 38% (n=111) were found to have a positive DeMeester, indicating a diagnosis of GORD. <b>Conclusions:</b> We demonstrate 68% of CC patients investigated with HROM had some degree of oesophageal dysmotility, with a lower prevalence of GORD. This suggests that motility disorders of the oesophagus, rather than acid reflux alone, may contribute the development and/or progression of CC.