The role of an anti-reflux diet in the treatment of chronic cough caused by laryngopharyngeal reflux.

Pavel Komínek, Karol Zeleník, Viktória Hránková, Tomáš Balner, Patrícia Gubová, Lucia Staníková, Adéla Kondé

Journal: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery 2025;282(4):2009-2013

PMID: 39994032

Abstract

PURPOSE

To evaluate the role of an anti-reflux diet in the treatment of patients with chronic cough caused by laryngopharyngeal reflux (LPR).

METHODS

This prospective observational study included patients with chronic cough (lasting over 3 months) and laryngopharyngeal reflux (LPR) confirmed by hypopharyngeal-esophageal 24-h multichannel intraluminal impedance-pH monitoring (HEMII-pH), according to Dubai criteria. Participants were categorized based on cough severity using a visual analog scale (VAS) from 1 to 10. A VAS < 5 was considered to indicate mild cough, whereas a VAS ≥ 5 were considered to indicate severe cough. Patients with mild cough were treated by anti-reflux diet only, while those with severe cough received additional treatment with proton pump inhibitors (PPIs) and alginates. After 3 months, treatment effectiveness was evaluated by assessing the reduction in cough severity.

RESULTS

In patients with mild cough, anti-reflux diet alone proved to be effective, yielding improvement in 83.3% of cases. Among patients with severe cough, a combination of anti-reflux diet, proton pump inhibitors (PPIs), and alginates proved was effective in 81.8% of cases.

CONCLUSION

Diet alone is an effective and sufficient treatment for mild chronic cough in patients with LPR. For patients with severe chronic cough with LPT, combined anti-reflux measures are effective.

© 2025. The Author(s).

Address: Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Ostrava, Ostrava, Czech Republic. [email protected].; Department of Craniofacial Surgery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic. [email protected].; Department of Allergology and Clinical Immunology, University Hospital of Ostrava, Ostrava, Czech Republic.; Department of Biomedical Sciences, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.; Department of Applied Mathematics, Faculty of Electrical Engineering and Computer Science, VSB- Technical University of Ostrava, Ostrava, Czech Republic.; Department of Deputy Director for Science, Research and Education, University Hospital Ostrava, Ostrava, Czech Republic.; Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Ostrava, Ostrava, Czech Republic.; Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Ostrava, Ostrava, Czech Republic.; Department of Craniofacial Surgery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.

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