Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0017168 (gastroesophageal reflux disease)
 11,783 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

On systematic investigation, patients with persistent cough are often diagnosed as having asthma, gastro-oesophageal reflux (GOR) and post-nasal drip; often, there is no associated diagnosis. Cough-variant asthma and eosinophilic bronchitis are conditions presenting with cough, usually associated with airway eosinophilia and responding well to corticosteroids. These conditions including asthma are best grouped as 'eosinophil-associated cough'. Analysis of induced sputum for eosinophils is an important tool in the investigation of chronic persistent cough. Reliable ambulatory counters for cough have been developed and the contribution of cough count and intensity to the severity of cough have been partly evaluated, and used in assessing antitussive therapies. Self-scoring evaluations are still widely used, but the inclusion of quality of life tools specifically adapted to the evaluation of cough appears to be a useful tool that can directly measure the impact of chronic cough. We need a greater assessment and evaluation of all these tools.
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PMID:Assessment and measurement of cough: the value of new tools. 1209 81

Cough is an important defensive reflex of the upper airway and is also a very common symptom of respiratory disease. Cough after an upper respiratory virus infection is transient, and persistent cough is associated with a whole range of conditions such as asthma, rhino-sinusitis, gastro-oesophageal reflux. Treatment directed at these conditions may improve the associated cough. There is often a need, however, to control cough itself, whatever the cause. The most effective drugs in this class are the opioids, such as morphine, codeine or pholcodeine, but at effective doses they have side-effects such as drowsiness, nausea, constipation and physical dependence. Investigations into the cough reflex and into the potential mechanisms of sensitised cough reflex have uncovered several potential targets for novel drugs. New opioids such as k- and d-receptor agonists apart from m-agonists have been developed, in addition to non-opioid, nociceptin. Neurokinin receptor antagonists, bradykinin receptor antagonists, vanilloid receptor VR-1 antagonists may be beneficial by blocking effects of tachykinins, and sensory nerve activation. Local anaesthetics, blockers of sodium-dependent channels, and maxi-K CA2+-dependent channel activators of afferent nerves are inhibitors of the cough reflex. Some of these novel agents may act centrally or peripherally or at both sites as antitussives. Large scale trials of these novel compounds have not been tried in cough in man, but there is a serious need for more effective antitussives devoid of side-effects.
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PMID:Therapy for cough: active agents. 1209 88

The discomfort caused by persistent cough compels a great number of patients to seek medical aid. Persistent cough interferes with the patient's sleep, professional and social activities. The pathogenic triad of asthma, post nasal drip syndrome and gastroesophageal reflux disease, alone or in combination, is responsible for the majority of cases of chronic cough. Investigation of chronic cough, according to a rational protocol leads to the identification of the cause for chronic cough in approximately 90% of the cases.
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PMID:[Chronic cough]. 1218 56

Cough is one of the atypical manifestations of gastroesophageal reflux disorder (GERD). The aim of this study was to evaluate the prevalence of GERD among patients presenting with persistent cough. The study included 80 patients over a period of 3 years. The inclusion criteria were nonsmoker adults with normal chest radiograph whose chief complaint was cough for at least 4 weeks duration. All patients included were subjected to nasal endoscopy, laryngoscopy, and 24-hour pH monitoring. Reflux was recorded in the different positions. Laryngeal signs of reflux were traced for and their significance was calculated. Patients who proved to have GERD received antireflux treatment with a follow-up of 3 months. The response to antireflux treatment was assessed according to subjective and objective improvement. Relapse in the follow-up period occurred in 9% of patients. It is concluded that laryngeal signs of GERD should be well known to diagnose and properly manage persistent cough.
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PMID:Persistent cough: prevalence of gastroesophageal reflux and study of relevant laryngeal signs. 1552 64

Cough is an important defensive reflex of the airway and also a common symptom of respiratory disease. Cough after common respiratory virus infection is transient but is more persistent when associated with conditions such as asthma, rhinosinusitis, gastro-oesophageal reflux, chronic obstructive pulmonary disease and lung cancer. Persistent cough may be due to peripheral and/or central sensitisation of cough reflexes initiated by cough receptors, rapidly adapting receptors or nociceptors. Treatment directed at associated conditions such as asthma (with anti-inflammatories) and gastro-oesophageal reflux (with proton-pump inhibitors) improve cough. There remains a need to use drugs that suppress the neural activity of cough (termed nonspecific), as treatments directed at the clinical cause(s) of the underlying cough (termed specific) may not be effective. The most effective indirect antitussives are opioids such as morphine, codeine or pholcodeine, but they produce side effects such as drowsiness, nausea, constipation and physical dependence. Opioids such as kappa- and delta-receptor agonists, non-opioids such as nociceptin, neurokinin and bradykinin receptor antagonists, cannabinoids, vanilloid receptor-1 antagonists, blockers of Na+-dependent channels, and large conductance Ca2+-dependent K+-channel activators of afferent nerves may represent novel antitussives.
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PMID:Drugs to suppress cough. 1570 18

Cough is an essential protective mechanism for the airways and lungs. Cough receptors are situated in the larynx and tracheobronchial tree, and are mediated by rapidly-adapting (irritant) Adelta fibers, although other receptors such as C-fiber receptors may contribute. Cough plasticity and interactions of cough pathways may occur centrally to enhance the cough reflex. The presence of an increased cough reflex as measured by a tussive response to capsaicin or citric acid in patients with a chronic cough indicate that there is sensitisation of the cough reflex. The most common cause of acute cough is that after a common cold, which usually lasts for less than 2 weeks. Cough that persists longer may be due to asthma and its variant forms (cough variant asthma and eosinophilic bronchitis), rhinosinusitis (postnasal drip), gastro-esophageal reflux, bronchiectasis, chronic bronchitis, and angiotensin-converting enzyme (ACE) inhibitor therapy. Chronic persistent cough can contribute to a significant worsening of quality of life measures. Bronchial tumors must be excluded with a chest radiograph. The management of chronic cough includes investigation and treatment of any associated causes, which sometimes leads to control of cough. In a proportion of patients, cough may be idiopathic and remain uncontrolled. Currently-available antitussives such as dextromethorphan or codeine are modestly successful in controlling cough. New antitussives may be developed that act on the sensory receptors or prevent their sensitisation.
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PMID:Pathophysiology and therapy of chronic cough. 1582 40

Eosinophil-associated conditions, such as asthma and eosinophilic bronchitis, have been associated with chronic persistent cough, usually responding to corticosteroid therapy. This case study reports a case of persistent cough associated with gastro-oesophageal reflux (GOR) and hypereosinophilia. Treatment of GOR with proton pump inhibitors and fundoplication did not control the cough. However, high dose prednisolone, but not inhaled corticosteroids, did. The presence of the FIP1L1-PDGFRA fusion gene in myeloid cells was confirmed by fluorescence in situ hybridisation analysis using CHIC2 deletion as a surrogate marker. The cough and other disease features were subsequently suppressed by the tyrosine kinase inhibitor, imatinib. This is the first case of persistent cough caused by hypereosinophilic syndrome characterised by FIP1L1-PDGFRA fusion gene and aberrant tyrosine kinase activity.
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PMID:Cough and hypereosinophilia due to FIP1L1-PDGFRA fusion gene with tyrosine kinase activity. 1638 54

Airborne pollutants can rise to extreme levels when large buildings fall down. The terrorist attack on New York's World Trade Center (WTC) towers caused the release of an enormous quantity of pulverized building materials and combustion products into the local environment. Particulate matter (PM) from crushed WTC building materials is primarily non-respirable (>96% larger than 10 microm mass median aerodynamic diameter [MMAD]) and composed of fibrous and nonfibrous components such as gypsum, calcite, silica, glass fibers, cellulose, and asbestos. Respirable fine WTC PM (PM(2.5)) may include finely crushed building materials as well as combustion products such as dioxins and polycyclic aromatic hydrocarbons (PAHs). Rescue workers at the WTC site had exposure-related increases in the incidences of nasal congestion, bronchial hyperreactivity to aerosolized methacholine, gastroesophageal reflux disease, and persistent cough. Toxicological studies in mice indicate that WTC PM(2.5) causes airflow obstruction above a critical dose. The review of physical characteristics and health effects of major pollutants derived from the collapse of the WTC towers has assisted in risk assessment efforts related to the collapse of large buildings.
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PMID:Physical characteristics and health effects of aerosols from collapsed buildings. 1655 Dec 19

Multichannel intraluminal impedance is a new technique for evaluating esophageal function and gastroesophageal reflux disease (GERD). This technique relies on the monitoring of electric conductivity in the esophagus though electrodes, and on changes developing in this variable as a result of bolus passage. The proximal distribution and duration of non-acid reflux events can now be quantified, and combined manometry defines the effectiveness of esophageal body function, until now only indirectly evaluated with pH changes. We discuss the case of a woman with persistent cough in whom intraesophageal multichannel impedance demostrates a minor acid reflux that could not be demonstrated with other diagnostic methods previously, and how this technique excludes any association between cough and non-acid reflux.
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PMID:[Multichannel intraluminal esophageal impedance: a new frontier in motility]. 1836 66

Persistent cough could be caused by various diseases such as postnasal drip syndrome, asthma and gastroesophageal reflux disease (GERD) or adverse event of drugs such as angiotensin-converting enzyme inhibitors. We report a case of persistent cough associated with high plasma levels of the proton pump inhibitor omeprazole in a patient with GERD. This case suggests cough as an adverse drug event to omeprazole, which is otherwise commonly prescribed for the management of GERD-related cough. Therefore, physicians should be aware of the onset or an exacerbation of cough during omeprazole therapy.
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PMID:Omeprazole-induced cough in a patient with gastroesophageal reflux disease. 1980 40


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