The Treatment of Cough (6)
In 1989, two studies reported on the treatment of chronic cough due to gastroesophageal reflux. In a prospective study involving nine patients, Irwin et al showed the following: (1) empiric therapy with an H2 blocker alone may not be adequate; (2) therapy was successful in all patients and included a high-protein, low-fat, anti-reflux diet, eating 3 meals per day without snacking, not eating or drinking except for taking medicines for 2 to 3 hours prior to lying down, elevation of the head of the bed, and metoclopramide or H2 blockers (or both); and (3) the resolution of cough with specific therapy was gradual, taking an average of 161 days. Fitzgerald et al, in a retrospective study involving 20 patients, reported a 90 percent success rate with specific therapy. A three-month course of medical therapy similar to that used by Irwin et al relieved cough in 14 of the 20 patients. Of the remaining six patients who continued to cough, four were asymptomatic three months after surgical antireflux therapy, one was lost to follow-up, and one refused surgery and remained symptomatic. Buy Advair Diskus Online
After reviewing the extensive literature on the efficacy of nonspecific antitussive treatment, we concluded the following about evaluating this form of therapy: (1) Although studies on artificially induced cough in animals and healthy subjects were important in order to determine which drugs should be selected for clinical trials, these studies by themselves could not be used to determine effectiveness, since their efficacy has not always been reproducible in patients with pathologic cough.