Chronic Cough Research Articles

Treatment of refractory chronic cough: current status and prospects

Refractory chronic cough (RCC) poses significant clinical challenges due to its refractoriness and limited therapeutic efficacy, profoundly impacting patients' quality of life and mental health. Currently, cough hypersensitivity is recognized as a common and treatable trait in RCC patients. In terms of treatment, neuromodulators and novel receptor antagonists/agonists are the primary pharmacological interventions, with gabapentin being widely utilized and P2X3 receptor antagonists considered promising. However, despite advancements in antitussive drug development targeting neuronal hypersensitivity reduction, their efficacy remains modest, and the development of novel antitussive agents faces numerous challenges. Furthermore, the application of non-pharmacological therapies in RCC management is still in its nascent stage, necessitating further research and exploration. This review aims to synthesize the current treatment landscape of RCC and to forecast future therapeutic strategies and research fields.

Interrupt a vicious cycle to Cure refractory chronic cough.

Interrupt a vicious cycle to Cure refractory chronic cough.

The silent scream: Unraveling vagal nerve neuralgia; VANCOUVER syndrome and HeLPS.

The silent scream: Unraveling vagal nerve neuralgia; VANCOUVER syndrome and HeLPS.

A Rare Case of Exophiala Dermatitidis Isolation in a Patient with Non-Cystic Fibrosis Bronchiectasis: Colonization or True Infection?

Background: Exophiala dermatitidis is a dematiaceous, thermotolerant, yeast-like fungus increasingly recognized as an opportunistic pathogen in chronic airway diseases. While commonly associated with cystic fibrosis, its clinical significance in non-cystic fibrosis bronchiectasis (NCFB) remains unclear. Case Presentation: We report the case of a 66-year-old immunocompetent woman with a history of breast cancer in remission and NCFB, who presented with chronic cough and dyspnea. Chest CT revealed bilateral bronchiectasis with new pseudonodular opacities. Bronchoalveolar lavage cultures identified E. dermatitidis, along with Pseudomonas aeruginosa and methicillin-sensitive Staphylococcus aureus. Given clinical stability and the absence of systemic signs, initial therapy included oral voriconazole, levofloxacin, doxycycline, and inhaled amikacin. Despite persistent fungal isolation on repeat bronchoscopy, the patient remained asymptomatic with stable radiologic and functional findings. Antifungal therapy was discontinued, and the patient continued under close monitoring. The patient exhibited clinical and radiological stability despite repeated fungal isolation, reinforcing the hypothesis of persistent colonization rather than active infection. Discussion: This case underscores the diagnostic challenges in distinguishing fungal colonization from true infection in structurally abnormal lungs. In NCFB, disrupted mucociliary clearance and microbial dysbiosis may facilitate fungal persistence, even in the absence of overt immunosuppression. The detection of E. dermatitidis should prompt a comprehensive evaluation, integrating clinical, radiologic, and microbiologic data to guide management. Voriconazole is currently the antifungal agent of choice, though therapeutic thresholds and duration remain undefined. Conclusions: This report highlights the potential role of E. dermatitidis as an under-recognized respiratory pathogen in NCFB and the importance of a multidisciplinary, individualized approach to diagnosis and treatment. This case underscores the need for further research on fungal colonization in NCFB and the development of evidence-based treatment guidelines. Further studies are needed to clarify the pathogenic significance, optimal management, and long-term outcomes of E. dermatitidis in non-CF chronic lung diseases.

Cough: A Reflex That Disrupts Interpersonal Communication.

The present study investigated the impact of chronic cough on the communication skills of patients. Two hundred adult patients with chronic cough (group 1, study group) and 196 healthy adult subjects without cough (group 2, control) were included in the study. The Leicester Cough Questionnaire (LCQ) and Communicative Competence Scale (CCS) were administered to both groups. Leicester Cough Questionnaire scores for the chronic cough group were significantly lower than those of the control group (P < 0.000). Since higher scores indicate better QoL, Group 1's QoLs were worse than those of the control group. The Communicative Competence Scale (CCS) scores for the chronic cough group were also significantly lower than those of the control group (P < 0.000). The authors' results indicate that chronic cough is associated with lower communication values and a poorer quality of life (QoL) for patients. Chronic cough can lead to a decrease in communication skills, potentially resulting in social problems. A decline in quality of life (QoL) is also observed in these patients. Therefore, timely and effective treatment of the cough is essential.

Rigid bronchoscopy and Y-stent for severe central malignant airway obstruction as a bridge to surgery requiring general anaesthesia.

A female patient in her 30s with a history of asthma presented with a chronic cough, worsening dyspnoea, dysphagia and a painless neck lump. Ultrasound revealed enlarged cervical lymph nodes and chest X-ray showed a large anterior mediastinal mass causing central airway obstruction. CT confirmed the mass partially encasing the superior vena cava. Due to concerns of airway collapse during surgery, interventional pulmonologists placed a silicone Y stent to restore airway patency before induction of anaesthesia for surgical lymph node biopsy. The excisional biopsy confirmed classic Hodgkin's lymphoma. The patient underwent chemotherapy (ABVD regimen) and had the stent removed after 2 months. She is in remission and continues follow-up.

Pulmonary Tuberculosis and Lung Abscess: A Case Report

A 49-year-old woman presented to the hospital with a chief complaint of dyspnea that began in the morning. She reported a history of hemoptysis, initially manifesting as clots equivalent to approximately one tablespoon, which has since diminished to blood-streaked sputum. A notable episode of hemoptysis had occurred one year prior, for which she was prescribed Anti-Tuberculosis Treatment (ATT). The patient has experienced a chronic cough since the previous year, with associated dyspnea during severe coughing episodes. She also reported intermittent fever. A thoracic examination revealed a normochest configuration with symmetric respiratory movements. Palpation identified decreased tactile fremitus in the right hemithorax. Percussion was hyperresonant and dull over the medial aspect of the right hemithorax. On auscultation, vesicular breath sounds were present bilaterally (+/+), with additional rhonchi noted (+/+) but no wheezing (-/-). Cardiac sounds I/II were pure and regular, with no additional sounds. A chest X-ray revealed cloudy opacities across both lungs, with a distinct patch containing an air-fluid level in the right lung. The heart size was normal, both sinuses were clear, and the right diaphragm was well-defined, while the left diaphragm showed tenting. The skeletal structures appeared intact. The radiological impression was pneumonia, a right lung abscess, and old left-sided tuberculosis.

Joint Clues to a Silent Killer: Hypertrophic Osteoarthropathy and Lung Cancer.

54-year-old male presented with dyspnea on mild exertion of mMRC grade II, chronic cough, pandigital clubbing (figure 1A) along with painful swelling involving distal part of both forearms for past 1 year. He is a chronic smoker since past 30 years with a smoking index of 680. Investigations revealed anemia of chronic disease with slight A/G reversal. X ray of forearm showed distal periosteal new bone formation along the shafts of radius and ulna with surrounding soft tissue swelling (figure 1B). A computer enhanced tomography of chest showed a heterogeneously enhancing mass along pleural surface on left hemithorax (figure 1C). FDG-PET showed hypermetabolic uptake in that mass with an SUVmax of 26.2 (figure 1D). He was diagnosed as hypertrophic osteoarthropathy secondary to lung carcinoma. A PET guided biopsy from the lung mass confirmed the histological type to be adenocarcinoma of lung. He was started on combination chemotherapy with Pemetrexed and Paclitaxel and is currently under medical oncology follow up.

Clinical Reasoning: A 57-Year-Old Man With Chronic Gait Unsteadiness and Diminished Lower Extremity Sensation.

A 57-year-old man presented with a 5-year history of progressive gait unsteadiness, diminished lower extremity sensation, and a chronic cough. His symptoms began as episodic balance issues and visual disturbances but progressively worsened, leading to frequent tripping. Physical examination revealed sensory deficits in the lower extremities and cerebellar signs, including nystagmus, dysmetria, and a broad-based gait. Readers will walk through a stepwise approach to the case, developing a comprehensive differential diagnosis and questioning likely etiologies to arrive at a final diagnosis. This case illustrates the challenges of diagnosing complex ataxia and highlights the importance of considering multisystem disorders.

Effect of Deep Breathing Exercises on Chronic Obstructive Pulmonary Disease: A Case-Based Report

Background: Chronic Obstructive Pulmonary Disease (COPD) is a progressive pulmonary disorder characterized by airflow limitation and chronic inflammation, significantly impacting quality of life and physical function. Non-pharmacological interventions, such as deep breathing exercises (DBEs), are gaining recognition as effective adjuncts in managing COPD symptoms.  Objective: To evaluate the effect of a structured deep breathing exercise program on pulmonary function, oxygenation, exercise capacity, and dyspnea in a patient with moderate COPD.  Case Presentation: A 65-year-old male with a three-year history of GOLD Stage II COPD presented with exertional breathlessness, chronic cough, and reduced stamina. Baseline spirometry revealed FEV1 of 58% predicted and a 6-minute walk test (6MWT) distance of 310 meters. A 4-week DBE protocol, including diaphragmatic breathing, pursed-lip breathing, thoracic expansion, segmental breathing, and incentive spirometry, was administered five days per week.  Outcomes: Post-intervention, the patient demonstrated improvements in SpO2 (from 89% to 94%), FEV1 (to 64% predicted), 6MWT distance (from 310 to 380 meters), and dyspnea (Borg score reduced from 4 to 2). Subjective reports included reduced breathlessness, improved sleep, and enhanced confidence in physical activity.  Conclusion: The incorporation of DBEs into COPD management resulted in clinically significant improvements in respiratory function, exercise tolerance, and quality of life. DBEs should be considered a valuable component of long-term pulmonary rehabilitation strategies.

Analysis of Electrocardiogram Changes in in COPD Patients and Controls in the Shahrekord City: A Cohort Study Population in 2020

&amp;lt;i&amp;gt;Background:&amp;lt;/i&amp;gt; Chronic Obstructive Pulmonary Disease (COPD) is one of the most prevalent and rapidly growing health problems worldwide. It is a progressive disease characterized by limited or obstructed airflow that is irreversible. &amp;quot;COPD is primarily caused by an excessive inflammatory response to inhaled pollutants and irritants, and is often characterized by a chronic cough, with or without mucus production. Chronic bronchitis and emphysema are the two conditions that comprise COPD, and they are not always precisely distinguishable. Due to the high prevalence of COPD among the elderly population, extensive studies have reported various electrocardiogram (ECG) changes in these patients. Examples include alterations in the axis and height of the P wave and a decrease in the height of the QRS complex in limb and precordial leads. Although not all COPD patients undergo routine ECG evaluations, the occurrence of various arrhythmias remains one of the significant and preventable causes of death in this population. Multiple factors, such as impaired autonomic control of cardiac and pulmonary function, may contribute to the development of arrhythmias in COPD patients. &amp;lt;i&amp;gt;Method:&amp;lt;/i&amp;gt; A total of 86 individuals diagnosed with COPD were selected through census sampling and considered the case group. For the control group, twice the number of participants (individuals without any obstructive pulmonary disease) were selected from the cohort population. Information on COPD patients were confirmed via spirometry, and their ECGs were analyzed for arrhythmias and abnormal changes.&amp;quot;. These included alterations in wave axes, lengthening or shortening of waves, changes in the R wave, and other deviations from the normal ECG pattern. The collected data were then analyzed and compared using statistical tests.&amp;lt;i&amp;gt; Findings:&amp;lt;/i&amp;gt; This study included 85 COPD patients and 168 healthy individuals as the control group, comprising a total of 253 participants. The mean age of the study population was 50.8 years, with 54% of the participants being female and 45% of the COPD patients being male. Significant ECG changes observed in COPD patients compared to the control group included weak progression of the R wave, atrial abnormalities (right atrial enlargement [RAE] and left atrial enlargement [LAE]), right ventricular hypertrophy (RVH), decreased QRS duration, and a short QT interval (&amp;lt;i&amp;gt;P-value &amp;lt; 0.05&amp;lt;/i&amp;gt;). &amp;lt;i&amp;gt;Conclusion:&amp;lt;/i&amp;gt; The observed ECG changes, such as weak R wave progression and atrial abnormalities, emphasize the importance of ECG as a non-invasive diagnostic tool for identifying cardiovascular complications in COPD patients. This highlights the need for regular cardiac monitoring in these individuals. Since certain cardiac complications in COPD patients are preventable or manageable, regular examinations such as ECG and echocardiography are recommended.

Tracheal Adenoid Cystic Carcinoma: A Case Report

Adenoid cystic carcinomas (ACC), or cylindromas, are malignant tumors of the trachea that represent 0.1% of respiratory tract cancers. This case involves a 79-year-old female patient admitted for chronic dry cough, intermittent dysphonia and dysphagia, along with unspecified weight loss. The chest CT scan revealed circumferential thickening of the trachea with endoluminal mass. Bronchoscopy showed a vascularized tumor nodule at the distal part of the trachea, and the biopsy confirmed a tracheal adenoid cystic carcinoma. The PET scan showed a distal tracheal neoplastic process extending to the carina, with mild FDG avidity, and moderate subaortic and subcarinal mediastinal lymph node hypermetabolism. The patient received external radiation therapy. The outcome was marked by improvement in cough and dysphagia.

Severity, mortality, long COVID-19, and quality of life: Insights from a cohort study of hospitalized COVID-19 patients during the delta variant predominance period in Thailand.

The COVID-19 pandemic, declared in March 2020, has had significant global impacts, with Thailand reporting over 4.6 million cases and 32,000 fatalities by September 2022. Long COVID, or Post-COVID Conditions (PCC), affects 10-30% of COVID-19 patients globally, with symptoms lasting beyond three months. Common issues include fatigue, brain fog, respiratory problems, and psychological effects such as anxiety and depression. Symptoms can persist regardless of the initial infection severity, and ongoing research continues to refine understanding and management strategies. To address residual symptoms of COVID-19 during the Delta variant predominance period, a study was conducted from July to December 2021 at a tertiary care hospital in Chiang Mai, Thailand. The study aimed to describe the characteristics of COVID-19 patients, explore the Long COVID symptoms experienced by patients after discharge, and assess their quality of life. The study characterized 604 are moderate to severe COVID-19 patients at Tertiary Care Hospital during the Delta wave in Thailand (July-December 2021), using secondary data from medical records. Confirmed cases were cohort monitored using a Long COVID questionnaire for symptoms, chronic conditions, and social impact a year after discharge. Quality of life was evaluated using the SF-12 questionnaire (SF-12: 12-Item Short Form Survey). Long COVID, in this study, is defined as the persistence or emergence of one or more physical, psychological, or cognitive symptoms that last for more than 12 weeks after the initial onset of COVID-19 and cannot be explained by alternative diagnoses. This includes, but is not limited to, symptoms such as fatigue, dyspnea, chest pain, cough, cognitive dysfunction ("brain fog"), insomnia, anxiety, or depression. Most patients were Thai (85.9%) and female (57.3%), with obesity common among those aged 18-60 (48.3%). Severe cases and mortality were higher in patients over 60 (30.2%) and unvaccinated patients (60.4%). Severity was related with male gender, older age, lack of antiviral use, and being unvaccinated; overweight status, comorbidities, and abnormal chest x-rays were not significant. Deaths were influenced by gender, age, and antiviral use, but not hospital stay duration, overweight status, comorbidities, or vaccination status. At one-year follow-up, Long COVID symptoms were reported in a small proportion of patients (4.2% shortness of breath, 1.5% chronic cough), mostly in adults and older adults. Other symptoms were rare (<1%) and limited to the 18-60 age group. No severe neurological or systemic symptoms were reported. One-year post-hospitalization, 79.15% had no Long COVID symptoms. Quality of life scores were high (Physical Component Summary: PCS = 48.62, Mental Component Summary: MCS = 50.65). This study found a very low prevalence of Long COVID symptoms, which may be due to the severity of the Delta variant leading to higher mortality among patients with severe illness. Those who survived and recovered mostly had moderate symptoms and were predominantly under 60 years of age, which may explain the lower occurrence of Long COVID in this group. The majority of COVID-19 patients in Chiang Mai experienced moderate symptoms and had a high survival rate. Despite varied long COVID symptoms, most reported good physical and mental health one year after recovery. These findings highlight the resilience of patients and the importance of monitoring long-term health outcomes.

Influence of Urinary Incontinence Related Factors on Health-Related Quality of Life in Patients with Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study

PurposeChronic obstructive pulmonary disease (COPD) is a progressive respiratory condition marked by airflow limitation and symptoms like chronic cough, breathlessness, and chest tightness. These factors, along with exacerbations and polypharmacy, may predispose COPD patients to urinary incontinence (UI). Unique challenges such as increased intra-abdominal pressure, pelvic floor weakness, and comorbidities may worsen UI and impair health-related quality of life (HRQoL). This study aimed to identify factors associated with UI severity in COPD patients and to examine its impact on HRQoL.MethodsThis cross-sectional study included 101 participants diagnosed with COPD who were reported to have UI. Participants completed the following questionnaires: the health status and UI severity were recorded using the COPD Assessment Test (CAT), International Consultation on Incontinence Questionnaire- Urinary Incontinence – short form (ICIQ-UI short form), and Incontinence Impact Questionnaire – short form (IIQ-7).ResultsUI severity was correlated with age, BMI, smoking, comorbidities, medications, chest tightness, and breathlessness. Severe UI predictors included age (OR=1.07), BMI (OR=1.09), and number of medications (OR=5.04), whereas breathlessness predicted moderate (OR=1.72) and severe UI (OR=1.87). Among COPD patients, 82.2% reported a mild impact of UI on HRQoL, and 6.9% reported a severe impact. Notably, among those experiencing moderate-to-severe HRQoL impairment, 63.6% had severe UI.ConclusionThis study highlights urinary incontinence (UI) as a prevalent and impactful comorbidity in individuals with COPD, significantly affecting their HRQoL. UI severity was associated with clinical factors such as older age, higher body mass index (BMI), greater medication burden, and breathlessness. Notably, greater UI severity corresponded to more substantial impairments in HRQoL, with severe cases reporting greater negative effects on daily functioning. These findings underscore the importance of routine screening for UI in COPD patients and the implementation of targeted continence care strategies to enhance overall quality of life.

Visual analysis of the research status and trends in acupuncture and moxibustion treatment for respiratory diseases in the past decade

To analyze the research progress, hotspots, frontier trends and existing limitations of acupuncture and moxibustion treatment for respiratory diseases in the past decade using bibliometric and scientific knowledge mapping methods. Literature on acupuncture and moxibustion treatment for respiratory diseases published from January 1st, 2014 to June 30th, 2024, from CNKI, VIP, Wanfang, PubMed and Web of Science was retrieved. CiteSpace 6.1.R6 and VOSviewer V1.6.20 were used to perform visual analysis, including keyword co-occurrence and clustering, and to construct knowledge maps of acupuncture and moxibustion treatment for respiratory diseases. A total of 1,106 Chinese articles and 185 English articles were included. High-frequency keywords focused on clinical diseases, treatment methods, efficacy observation, mechanisms etc. The main respiratory diseases treated with acupuncture and moxibustion included chronic obstructive pulmonary disease (COPD), asthma and cough. Commonly used acupoints included Feishu (BL13), Zusanli (ST36), Dazhui (GV14) and Shenshu (BL23), primarily involving the bladder meridian of foot-taiyang, conception vessel and lung meridian of hand-taiyin. Among the treatment methods dominated by acupuncture and moxibustion, the primary treatment method was electroacupuncture combined with moxibustion, and acupoint application was supplemented, with increasing emphasis on integrative Chinese and Western medicine and acupuncture combined with medication. The therapeutic mechanisms involved anti-inflammatory effects and inhibition of airway remodeling, with targets mainly associated with the NF-κB signaling pathway. Acupuncture and moxibustion demonstrates certain advantages in treating respiratory diseases such as COPD, asthma and cough, with mechanisms related to anti-inflammatory effects and inhibition of airway remodeling. Future research should focus on multi-center, large-sample, high-quality clinical and experimental studies to explore the optimal clinical treatment protocols and underlying mechanisms.

The Effect of Attentional Manipulation on Cough Reflex Sensitivity in Individuals with Refractory Chronic Cough and Healthy Controls

Background: Cough reflex sensitivity during cough challenge testing has been found to be modifiable with distraction in groups of healthy individuals. The purpose of this study was to examine this phenomenon in healthy controls and patients with refractory chronic cough (RCC) to advance our understanding of the role attention plays in cough modulation and shed light on avenues for therapeutic advances for RCC. Methods: Thirteen adults with RCC (mean age = 60, 12 women) and twelve healthy controls (mean age = 60, 11 women) participated in this study. The participants completed cough challenge testing with nebulized capsaicin doses tailored to their individual cough reflex sensitivity under distraction and no-distraction conditions. The distraction condition consisted of cough challenge testing while completing a cognitive (visual memory) task on a tablet. Capsaicin doses included the dose that elicited two coughs (C2), and up to three doubling doses above C2. Capsaicin doses were administered in serial order with a placebo dose randomized into the order to control for an anticipation effect during each condition. For each dose administered, the participants were instructed to cough if they needed to. Cough frequency within 15 s and maximal urge-to-cough with each dose were recorded. The order of conditions (distraction or no distraction) was alternated, and all testing was completed within one session. Results: There were no meaningful differences in the dose–response rate parameters for cough frequency or urge-to-cough, respectively, when comparing the results from the RCC group in the condition without distraction to the condition with distraction (p = 0.647, 95% CI = −2.25, 1.15; p = 0.783, 95% CI = −1.94, 0.84), and to the healthy control group without distraction (p = 0.921, 95% CI = −2.11, 2.73, p = 0.887, 95% CI = −1.40, 0.80), and with distraction (p = 0.970, 95% CI = −2.16, 3.36), p = 0.808, 95% CI = −1.49, 0.89). Conclusions: Distraction with the cognitive task chosen in this study did not influence cough reflex sensitivity in either group, which is contrary to studies on healthy volunteers and anecdotal evidence reported by RCC patients. Attentional resources may not have been sufficiently taxed, or too few capsaicin doses were administered to capture an effect as there was high individual variability in cough frequency and urge-to-cough. Additional research is needed to tailor the difficulty of the cognitive task to each participant and incorporate a real-world distraction scenario that may better reveal how attentional manipulation could be harnessed to optimize the effectiveness of behavioral cough suppression therapy for patients with refractory chronic cough.

Psychometric validation of the severity of chronic cough diary, leicester cough questionnaire, and a cough severity visual analogue scale in patients with refractory chronic cough

BackgroundRefractory chronic cough (RCC) is commonly reported in primary care and associated with significant morbidity. Patient-reported outcome (PRO) measures are important for evaluating the efficacy of antitussive medications for RCC in clinical trials from the patient-perspective. Psychometric properties of Severity of Chronic Cough Diary (SCCD) Cough Severity and Cough Frequency, Leicester Cough Questionnaire (LCQ) Total and Physical Domain and Cough Severity Visual Analogue Scale (VAS) scores using data from a 12-week Phase 2b trial evaluating the efficacy of eliapixant in patients with RCC (NCT04562155) are reported.ResultsQuality of completion for the SCCD, LCQ and Cough Severity VAS across the study was high, no ceiling or floor effects were observed at baseline. Internal consistency for LCQ Total and Physical domain scores was also high (Cronbach’s alpha = 0.939 and 0.806, respectively). SCCD Cough Frequency and Cough Severity, LCQ Total and Physical domain, and Cough Severity VAS scores demonstrated strong test-retest reliability (Intraclass correlation coefficient ≥ 0.848) among participants defined as stable between Week 3 and Week 4 according to Patient Global Impression of Severity (PGI-S) ratings and Awake Cough Count readings. Construct validity was supported by known-groups comparisons, with large differences (effect sizes 1.99–4.16) observed between groups categorized according to PGI-S ratings and objective Awake Cough Counts. Ability to detect improvement was supported by large effect sizes (≥0.8) observed for mean changes in SCCD, LCQ and Cough Severity VAS scores from baseline to Week 12 among participants classified as ‘improved’ according to PGI-S/PGI-C ratings and Awake Cough Counts. Triangulated thresholds (score range) for meaningful within-patient improvement based on anchor-based assessments were -0.82 for SCCD Cough Frequency (0–4), -0.69 for SCCD Cough Severity (0–4), 2.36 for the LCQ Total (3–21), 0.77 for the LCQ Physical (1–7) and -17.73 for the Cough Severity VAS (0–100) scores.ConclusionFindings support the reliability, validity and responsiveness of the newly developed SCCD Cough Frequency and Severity items as fit-for-purpose PRO measures of cough frequency or severity for use in drug development programs within RCC. The LCQ Total, LCQ Physical Domain and Cough Severity VAS also exhibit acceptable measurement properties for use in this population.

Childhood gastroesophageal reflux disease: A comprehensive review of disease, diagnosis, and therapeutic management.

Gastroesophageal reflux disease (GERD) affects both adults and children, although the symptoms differ significantly between these groups. While adults typically experience heartburn and regurgitation, children may present with more subtle signs, such as failure to thrive, chronic cough, wheezing, and Sandifer syndrome. Diagnosing GERD in children necessitates a multifaceted approach due to the diverse symptomatology and challenges in communication. Clinical assessment serves as the cornerstone of diagnosis, supported by tools like pH monitoring, esophageal impedance testing, and upper gastrointestinal endoscopy. Imaging studies, such as barium swallow, can also provide valuable insights into anatomical abnormalities and the extent of reflux. Treatment strategies for pediatric GERD include lifestyle adjustments, pharmacotherapy, and, in severe cases, surgical interventions. Lifestyle adjustments may involve changes in feeding patterns, positional therapy, and weight management. Pharmacological options range from acid suppression with proton pump inhibitors or histamine-2 receptor antagonists to surgical procedures like fundoplication for refractory cases. Personalized management is essential, considering the child's age, symptom severity, and the presence of complications. This article aims to offer a comprehensive understanding of pediatric GERD by utilizing current research to enhance clinical approaches and improve patient outcomes.

Reply to Rui and Chen: Initial Success: Camlipixant in Refractory Chronic Cough

Reply to Rui and Chen: Initial Success: Camlipixant in Refractory Chronic Cough

Initial Success: Camlipixant in Refractory Chronic Cough.

Initial Success: Camlipixant in Refractory Chronic Cough.