ABSTRACT
In patients with chronic cough who are systematically evaluated the cause is
one or more of postnasal drip syndrome, cough-variant asthma, or gastroesophageal reflux disease (GERD) in 90% (1,2). There have been major advances in the diagnosis and management of GERD in recent years and
there is now consensus in the management of many aspects of this very
common condition (3-5). The management of patients with cough due to
GERD, however, remains a challenging problem requiring an understanding
of management of both cough and gastroesophageal reflux. The more diffi-
cult patients are best managed by a multidisciplinary team with a pulmon-
ary physician, a gastroenterologist, and an experienced esophageal surgeon capable of performing laparoscopic surgery. This chapter will present an
overview of the current approach to the diagnosis and management of
GERD based on recent consensus documents and systematic overviews,
discuss the currently available literature regarding the treatment of gastro-
esophageal reflux in patients with chronic cough, and finally present a prac-
tical approach to the assessment and treatment of these patients.