Cough in Adult Cystic Fibrosis: Diagnosis and Response to Fundoplication
Author Information
Author(s): Fathi Hosnieh, Moon Tanya, Donaldson Jo, Jackson Warren, Sedman Peter, Morice Alyn H
Primary Institution: Hull York Medical School, University of Hull
Hypothesis
In CF patients with reflux cough not responding to maximal medical therapy, laparoscopic Nissen fundoplication (LNF) could be an alternative approach.
Conclusion
Fundoplication is highly effective in controlling reflux cough in CF and may significantly reduce exacerbation frequency.
Supporting Evidence
- Significant abnormalities of oesophageal function were seen in all patients studied.
- Mean number of reflux episodes was 144.4, and mean DeMeester score was 39.2.
- Post fundoplication, cough severity improved significantly as measured by the LCQ.
- Exacerbation events were reduced by 50% post-operatively.
Takeaway
This study found that a surgery called fundoplication can help people with cystic fibrosis who have a bad cough caused by stomach acid coming up.
Methodology
Patients with refractory cough were assessed by 24 h pH monitoring and oesophageal manometry, and pre-and post-operation cough, lung function, and exacerbation frequency were compared.
Potential Biases
The study may have bias due to the lack of a control group.
Limitations
This is a non-controlled study, and regression to the mean or a placebo effect cannot be discounted.
Participant Demographics
6 adult patients with cystic fibrosis, mean age 34.5 years, including 2 females.
Statistical Information
P-Value
P = 0.01
Confidence Interval
95% CI: 2.2 to 10.4
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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