Chronic cough, asthma, and gastroesophageal reflux

Curr Gastroenterol Rep. 2000 Jun;2(3):217-23. doi: 10.1007/s11894-000-0064-2.


Gastroesophageal reflux disease (GERD) causes chronic cough and triggers asthma. Mechanisms of reflux-associated chronic cough include micro- and macroaspiration, laryngeal injury, and a vagally mediated reflex. An empiric trial of a proton pump inhibitor in patients without other etiologies of cough found through diagnostic testing may be an effective diagnostic strategy for GERD-associated cough. In GERD-associated asthma, there is evidence of neurogenic inflammation. Medical or surgical therapy of GERD results in asthma symptom improvement in about 70% of patients. A 3-month empiric trial of omeprazole, 20 mg daily, followed by esophageal pH testing in drug nonresponders, is the most cost-effective way of diagnosing asthma triggered by GERD.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Anti-Ulcer Agents / therapeutic use
  • Asthma / diagnosis
  • Asthma / etiology*
  • Asthma / physiopathology
  • Chronic Disease
  • Cough / diagnosis
  • Cough / etiology*
  • Cough / physiopathology
  • Gastroesophageal Reflux / complications*
  • Gastroesophageal Reflux / physiopathology
  • Gastroesophageal Reflux / therapy
  • Humans
  • Hydrogen-Ion Concentration
  • Monitoring, Physiologic
  • Omeprazole / therapeutic use


  • Anti-Ulcer Agents
  • Omeprazole