open access

Vol 82, No 6 (2014)
Submitted: 2014-10-22

The utility of oesophageal pH monitoring in diagnosing gastroesophageal reflux disease-related chronic cough

Aleksandra Rybka, Kamila Malesa, Olga Radlińska, Karolina Krakowiak, Elżbieta M. Grabczak, Marta Dąbrowska, Ryszarda Chazan
DOI: 10.5603/PiAP.2014.0065
Pneumonol Alergol Pol 2014;82(6):489-494.

open access

Vol 82, No 6 (2014)
Submitted: 2014-10-22


Introduction: Chronic cough is a common medical complaint, which may deteriorate patients’ quality of life and cause many complications. Gastroesophageal reflux disease (GERD) is one of the frequent reasons for chronic cough. Oesophageal pH monitoring is one of the diagnostic methods performed to confirm diagnosis of GERD-related cough. The aim of the study was to analyse the utility of oesophageal pH monitoring in diagnosing GERD-related cough and to identify the most sensitive pH monitoring parameters for diagnosing GERD-related cough.

Material and methods: 24-hour oesophageal pH monitoring was performed in 204 patients suffering from chronic cough. The group consisted of 65% females and the median age was 59 years. An acid reflux episode was defined as a rapid drop in pH to a value below 4 for at least 12 seconds. The diagnosis of GERD was based on total fraction time of pH < 4, upright or supine fraction time of pH < 4, or DeMeester score. The diagnosis of GERD-related cough was made if cough episodes, marked by the patients, appeared within 2 minutes after the reflux. The association between reflux episode and appearance of cough was analysed using two parameters: symptom index (SI ≥ 50%) and/or symptom association probability (SAP ≥ 95%).

Results: Based on results of pH monitoring, 135 patients (135/204, 66%) were diagnosed with GERD. Among them, 117 patients (117/135, 87%) were diagnosed based on DeMeester score. Among patients with GERD, 61 patients met the criteria of GERD-related cough (61/135, 45%), i.e. 30% of the group as a whole. Thirty-six patients (36/61, 59%) were diagnosed based on SAP, 12 patients (20%) based on SI, and 13 (21%) based on both parameters. Spearman rank correlation coefficient for SAP ≥ 95% and SI ≥ 50% was 0.46 (p < 0.05).

Conclusions: Based on pH monitoring results, GERD was diagnosed twice as often as GERD-related cough. SAP index is more sensitive than SI for the diagnosis of GERD-related cough.


chronic cough, oesophageal pH monitoring, gastroesophageal reflux disease

About this article

The utility of oesophageal pH monitoring in diagnosing gastroesophageal reflux disease-related chronic cough


Advances in Respiratory Medicine


Vol 82, No 6 (2014)





Bibliographic record

Pneumonol Alergol Pol 2014;82(6):489-494.


chronic cough
oesophageal pH monitoring
gastroesophageal reflux disease


Aleksandra Rybka
Kamila Malesa
Olga Radlińska
Karolina Krakowiak
Elżbieta M. Grabczak
Marta Dąbrowska
Ryszarda Chazan

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