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Chronic cough is defined as persistent cough for more than eight weeks without a defined diagnosis. Irwin and other authors have identified sinusitis, asthma and gastroesophageal reflux as the most common causes of chronic cough. Objectives: To know the clinical spectrum and the most common causes of chronic cough, as well as lo perform a comparative analysis with the literature. Material and methods: A retrospective and transversal study was performed analyzing the clinical records of patients attending consultation because of chronic cough at Dr. Jose E. Gonzalez University Hospital at the Autonomous University of Nuevo Leon, and the Clínica Cuauhtemoc y Famosa, in Monterrey, Nuevo Leon, Mexico, from January, 1998, to December, 2000. The main symptoms and signs of each patient were analyzed, as well as the final diagnosis of the cough's cause and the response to treatment. In addition, a comparative analysis of the data found. In this population and those reported by Irwin et al on the main cause of this symptom. For the statistical analysis, multivarianza analysis, x2 test and Mantel Haenszel with 2x2 table were used considering a p < 0 05 as significant. Results: One hundred eight records were reviewed, but only 91 were included. The most common final diagnoses were gastroesophageal reflux in 75 patients (82%), followed by sinusitis in 34 cases (37%) and mixed causes (more than two) in 25 subjects (27%) (p = 0 016). All patients responded properly to specific treatment directed to the identified base-disease, with which symptoms were solved. Conclusions: In our population, unlike described by Irwin, the most frequent cause of chronic cough is gastroesophageal reflux, followed by sinusitis and mixed causes. [ABSTRACT FROM AUTHOR]

Cough is the common symptom of patients who seek medical attention; chronic cough being defined as persistent cough longer than three weeks without a definite diagnosis. Cough is a vagal phenomenon which can be initiated in structures with afferences of the vagus or its branches; besides, cough receptors have been described in different parts of the body, mainly tracheobronchial and digestive tract structures, which send afferents to the central nervous system to form the cough reflex. Main causes of chronic cough are retronasal discharge syndrome, gastroesophagic reflux and asthma. The diagnosis of chronic cough requires a careful history and physical examination and paraclinic tests focused on the most frequent causes. Treatment is oriented to identify and correct the disease; anticough medication should be used carefully since cough is a defense mechanism and an alarm sign. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the prevalence of GERD (gastroesophagic reflux disease) as well as the clinical, endoscopic and manometric characteristics of patients with atypical symptoms. Methods: Fifty-seven adult patients with otolaryngeal manifestations, asthma or non-cardiac chest pain were included in the study. The prevalence of GERD by means of 24-hour esophageal pH monitoring and the demographic, clinical, endoscopic and manometric characteristics of the patients with or without GERD were evaluated. GERD patients were randomly assigned to receive cisaprida and pantoprazole as a therapeutic test. Symptom response was evaluated using the Visual Analogue Scale. Results: Of the 57 patients studied, 34 had GERD (60%). The 95% confidence interval ranged from 48 to 72%. There was no statistical difference between both groups regarding gender, age or evolution time of symptoms. Cough was more frequent in subjects with GERD (75 vs. 25%, p < 0.05) and dysphagia was more common in the patients without GERD (78 vs. 22%. p < 0.05). Nevertheless, cough was present in only 53% of the patients with GERD and dysphagia was present in only 30% of patients without GERD. There was no difference between the two groups with respect to the other evaluated atypical symptoms. Patients with GERD showed a higher incidence of esophageal laryngitis, hiatal hernia, Barret mucosa, hypotonic LES and abnormal peristalsis than those without GERD. Patients suffering laryngitis had greater proximal acid exposure time and symptoms index than those without. After completion of treatment, 74% of patients showed partial or complete response. Conclusions: The prevalence of GERD in our population was 60% in patients with atypical symptoms. There is neither a definite demographic nor a clinical profile that permit us to distinguish between patients with or without GERD. Patients with laryngitis showed more intense proximal reflux than those without laryngitis. Erosive esophagitis is not common in those patients with GERD. Finally, the response to treatment in the majority of the patients permits us to establish a cause-and-effect relationship. [ABSTRACT FROM AUTHOR]