315 Diagnosis of Gastroesophageal Reflux Disease in Patients with Chronic Cough

BACKGROUND: A major cause of chronic cough is gastroesophageal reflux disease (GERD). Its diagnosis is based on symptoms and diagnostic tests, such as upper gastrointestinal endoscopy (UGE), 24-hour pH monitoring and manometry. Many patients also present chronic posterior laryngitis in fibronasolaryngoscopy (FNL). The objective of the present study was to evaluate the diagnosis of esophagitis, by FNL and UGE in patients with chronic cough. METHODS: Patients followed up for chronic cough, over 18 years of age, were asked about the presence of GERD symptoms and submitted to the FNL and UGE, some of them with esophageal biopsy. RESULTS: Fifty-one patients participated in the study. The average age was 56.8 years (±13.2 years), 90.2% were female and the average duration of cough, 12.2 years (±14.9 years). Of these, 46 (90.2%) had dyspepsia, and partial or complete improvement of symptoms of cough with proton pump inhibitor. Of the 46 symptomatic patients, only 18 (39.1%) had esophagitis on UGE; however, 36 patients (78.3%) had posterior laryngitis on FNL. Seventeen patients also underwent esophageal biopsy, and 15 examinations identified esophagitis. Nine (60%) of these patients had only posterior laryngitis on the FNL (UGE without esophagitis). CONCLUSIONS: Fibronasolaryngoscopy was more sensitivity than upper gastrointestinal endoscopy to confirm gastroesophageal reflux disease. Although the indication for biopsy of esophagus follows standardized criteria, this study suggests that in patients with chronic cough, if there is an indication for the performance of UGE, it would be interesting to complement with biopsy of the esophagus.