GERD

Persistent cough, chest pain may be symptoms of GERD,

"Severe chest pain and persistent cough" could be "serious manifestations of acid reflux," according to two studies presented at the 72nd American College of Gastroenterology annual scientific meeting in Philadelphia. One study, which included 31 patients who went to the emergency room "complaining of serious chest pain," showed that "[a]bnormal reflux of acid was [present] in 57 percent."

The other study of 701 of patients with gastroesophageal reflux disease (GERD) found that nearly 75 percent of patients with GERD "suffer nighttime symptoms not typically associated with the disease such as coughing, snoring, and chest pain." The findings "also showed that those who suffered uncommon symptoms two or more nights a week were much more likely to have trouble falling asleep and staying asleep than those who suffered the typical symptoms of heartburn and acid regurgitation."


GERD patients continue to experience reflux despite twice-daily dosing with a PPI,

"Most patients with [GERD] continue to have [non-acidic] reflux despite twice-daily dosing with a proton pump inhibitor (PPI)," according to a study presented at the meeting. "The study involved 167 patients who underwent [multichannel intraluminal impedance and pH (MII-pH)] studies while on twice-daily PPI therapy." The researchers discovered that "22% to 50% of patients had abnormal findings," which were defined as "48 reflux episodes." They also found that there was no significant difference among patients taking different PPIs.


Study links psychological distress with more severe symptoms of GERD.

"Apparent treatment-resistant [GERD] may reflect comorbid psychological distress that results in more severe symptoms," according to research reported at the gastroenterology meeting. Researchers "studied 101 patients who underwent esophagogastroduodenoscopy for evaluation of persistent heartburn. Testing revealed that 67 patients had nonerosive reflux disease and 34 had erosive esophagitis." After assessing "psychological status," the researchers noted that "39% of the patients had comorbid psychological distress."

Following eight weeks of therapy with PPIs, the researchers found that "[p]atients with and without psychological distress improve[d] to a similar degree, but those with psychological distress [had] more residual symptoms because they had more severe baseline symptoms."