Scholarlink

AIMS <p>Gastroesophageal Reflux Disease (GERD) is a common cause of chronic cough. Transoral incisionless fundoplication (TIF) or TIF with concomitant hiatal hernia repair (cTIF) may be suitable treatments. We studied the effectiveness of TIF/cTIF in patients with chronic cough and proven GERD.</p> Methods <p>Patients with proven GERD from 9 centers (TIF registry) were evaluated before and at a minimum of 6&#xa0;months post TIF/cTIF. Patients with cough-predominant phenotype were identified (chief complaint of cough and reflux symptom index (RSI) troublesome cough subscore ≥ 2) and compared to those without. The primary outcome was improvement in RSI score compared to baseline. Secondary outcomes were normalization of RSI, improvement in RSI cough sub-scores, GERD symptom improvement, discontinuation of proton pump inhibitor, and patient satisfaction.</p> Results <p>One hundred and ninety-eight patients underwent TIF/cTIF. Follow-up for 177 patients (median 12 months [IQR 6,12]) showed decrease in median RSI score from 18 [IQR 13, 27] to 5 [IQR 2, 11] (<i>p</i> &lt; 0.0001). Eighty-three percent of patients with elevated baseline RSI normalized their scores. Seventy-five percent and 72% had improvement in cough when lying down and troublesome cough, respectively. Eighty-three percent successfully discontinued or decreased PPI. Satisfaction improved from 5.6% at baseline to 68.8% (<i>p</i> &lt; 0.0001). Patients with cough-predominant phenotype (<i>n</i> = 63) experienced an additional 5-point decrease in in RSI score (<i>p</i> = 0.01). Patients with typical GERD symptoms were more likely to have a favorable response for cough symptoms (<i>p</i> &lt; 0.0001).</p> Conclusion <p>TIF/cTIF are effective barrier therapies for patients with cough-predominant pH-positive GERD.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Effectiveness of transoral endoscopic fundoplication with or without hiatal hernia repair in patients with gerd and chronic cough

  • 期刊论文

  • 发表日期：

    2025年10月2日

查看全文
  • Eric Swei,
  • Jose A. Almario,
  • Kerry Dunbar,
  • Rena Yadlapati,
  • Brett Parker,
  • Olaya Brewer-Gutierrez,
  • Peter Janu,
  • Michael Murray,
  • Amit Sohagia,
  • David L. Diehl,
  • Harshit Khara,
  • Barham Abu Dayyeh,
  • Reem Sharaiha,
  • Rasa Zarnegar,
  • Jennifer M Kolb,
  • Ninh Nguyen,
  • Kenneth Chang,
  • Marcia I. Canto

摘要

AIMS

Gastroesophageal Reflux Disease (GERD) is a common cause of chronic cough. Transoral incisionless fundoplication (TIF) or TIF with concomitant hiatal hernia repair (cTIF) may be suitable treatments. We studied the effectiveness of TIF/cTIF in patients with chronic cough and proven GERD.

Methods

Patients with proven GERD from 9 centers (TIF registry) were evaluated before and at a minimum of 6 months post TIF/cTIF. Patients with cough-predominant phenotype were identified (chief complaint of cough and reflux symptom index (RSI) troublesome cough subscore ≥ 2) and compared to those without. The primary outcome was improvement in RSI score compared to baseline. Secondary outcomes were normalization of RSI, improvement in RSI cough sub-scores, GERD symptom improvement, discontinuation of proton pump inhibitor, and patient satisfaction.

Results

One hundred and ninety-eight patients underwent TIF/cTIF. Follow-up for 177 patients (median 12 months [IQR 6,12]) showed decrease in median RSI score from 18 [IQR 13, 27] to 5 [IQR 2, 11] (p < 0.0001). Eighty-three percent of patients with elevated baseline RSI normalized their scores. Seventy-five percent and 72% had improvement in cough when lying down and troublesome cough, respectively. Eighty-three percent successfully discontinued or decreased PPI. Satisfaction improved from 5.6% at baseline to 68.8% (p < 0.0001). Patients with cough-predominant phenotype (n = 63) experienced an additional 5-point decrease in in RSI score (p = 0.01). Patients with typical GERD symptoms were more likely to have a favorable response for cough symptoms (p < 0.0001).

Conclusion

TIF/cTIF are effective barrier therapies for patients with cough-predominant pH-positive GERD.