Gastroesophageal reflux disease and sinusitis: their role in patients with chronic cough.

The causes of coughing are multiple. Research into the physiology of coughing has established that interactions amid C-fibers and rapidly activating receptors in humans have the most significant effect on stimulation of coughing. Precipitants of coughing include gastroesophageal reflux and sinusitis. Stimulation of vagal afferents by esophageal irritation and aspiration of acidic gastric contents or vapors are the most frequently cited causes of cough associated with gastroesophageal reflux or laryngopharyngeal reflux. Sinusitis may precipitate coughing from other mechanisms including aspiration of postnasal drainage and sinopulmonary reflex. Taking a lesson on how these conditions affect asthmatic patients, this article will review how these two conditions may also influence cough in normal patients.