{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:27:19Z","timestamp":1788413239651,"version":"build-2803163510"},"reference-count":47,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2019,9,3]],"date-time":"2019-09-03T00:00:00Z","timestamp":1567468800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The pathophysiological mechanism(s) of gastroesophageal reflux disease (GERD)\u2010related chronic cough (CC) is unclear. We aimed to determine the mechanism of reflux\u2010induced cough by synchronous monitoring of reflux episodes, esophageal motility, and cough.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with GERD were prospectively enrolled and classified into GERD with CC (GERD\u2010CC) and without CC (GERD) groups. Twenty\u2010four\u2010hour ambulatory pH\u2010impedance\u2010pressure monitoring was performed; the reflux patterns, esophageal motility during prolonged exposure to acid and characteristics of reflux episodes that induced coughing paroxysms were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Thirty\u2010one patients with GERD\u2010CC and 47 with GERD were enrolled; all of whose monitoring results fulfilled the criteria for diagnosis of GERD. Patients with GERD\u2010CC had higher reflux symptom scores, longer exposure to acid, higher DeMeester scores, and more frequent reflux episodes, proximal extent reflux detected by impedance, and higher percentage of strongly acidic reflux than patients in the GERD group (all <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.05). Of 63 reflux\u2010cough episodes identified in the GERD\u2010CC group, 74.6% of distal reflux and 67.0% of proximal reflux episodes were acidic. More patients had low pan\u2010esophageal pressure in primary peristalsis (48.5% vs 11.8%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.000) and synchronous contraction in secondary peristalsis during prolonged exposure to acid in the GERD\u2010CC than in the GERD group (63.9% vs 9.1%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.000).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Inferences<\/jats:title><jats:p>Proximal acidic reflux and distal reflux\u2010reflex are jointly associated with reflux\u2010induced cough in patients with GERD. Low pan\u2010esophageal pressure in primary peristalsis and synchronous contraction in secondary peristalsis may play important roles in GERD\u2010associated chronic cough.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.13707","type":"journal-article","created":{"date-parts":[[2019,9,4]],"date-time":"2019-09-04T08:10:27Z","timestamp":1567584627000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Gastroesophageal reflux disease and chronic cough: A possible mechanism elucidated by ambulatory pH\u2010impedance\u2010pressure monitoring"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1334-1544","authenticated-orcid":false,"given":"Xiaoqing","family":"Li","sequence":"first","affiliation":[{"name":"Departement of Gastroenterology Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 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