CHRONIC COUGH ASSOCIATED WITH GASTROINTESTINAL DYSFUNCTION

Abstract

Chronic, persistent cough is a common clinical problem, the cause of which sometimes remains unidentifiable. Gastroesophageal reflux disease (GERD), such as manifestation of gastrointestinal dysfunction, is one of the most common causes of chronic cough. Some studies have suggested that helminth infections induce or increase the severity of cough. Based on the above, the presented study is aimed at screening and identifying gastrointestinal dysfunction such as extrapulmonary conditions, which are reasons for chronic, persistent cough in the West Georgian population. 46 patients (18 to 75 years of age, 24 women and 22 men) who applied to the National Institute of Allergology, Asthma and Clinical Immunology of the Georgian Academy of Sciences (Tskaltubo, Georgia) for diagnostic were involved in the study. The research design included: 1) collection of anamnesis - via a specially designed questionnaire for collecting the medical history; 2) To clarify the common etiologic factor of gastrointestinal dysfunction, conduction of laboratory examinations including detection of total IgM, IgG titers on Helicobacter pylori; also total IgA, IgM, IgG titers on helminths: Giardia, Ascaris, Toxocara, was scheduled. Based on the analysis of medical history and specific instrumental-laboratory markers in 17 (37%) patients out of 46 with cough, gastrointestinal dysfunction was revealed. Detection of Helicobacter pylori showed an increase in the level of this marker in 6 (35%) patients from 17, established the antibodies in blood on Helicobacter pylori. The laboratory examinations detected an increased level of total IgM in 1(5,8%) case, and IgG titers were increased in 5 (29%) patients on Helicobacter pylori. In addition, the antibodies against all three analyzers on helminths showed: Giardia, Ascaris and Toxocara were revealed. In parallel to the treatment under the Cough State Protocol/Guidelines, the patients were administered antihelminth therapy, resulting in a reliable solution – recovery. Ultimately, the gastroenterologist can play a key role in supporting a systematic, multi-disciplinary approach to refractory cough that judiciously utilizes diagnostic testing and treatment strategies.