© 2005 by BMJ Publishing Group Ltd & British Society of Gastroenterology
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Gastroenterologists are often referred patients with persistent cough from their ENT colleagues with the question "Could this be reflux induced cough?" Traditional pH recordings demonstrate a strong association between reflux and cough in some, but others remain a mystery. The study from Leuven of 22 such patients shows that oesophageal impedance monitoring can detect non-acidic reflux, which is missed by traditional pH monitoring. Ten patients were shown to have reflux induced cough and three of these would have been missed using traditional pH monitoring alone. Because this leads to significantly different treatment, patients with unexplained chronic cough should have oesophageal impedance monitoring if clinical impressions are not supported by 24 hour pH recordings.
See p 449
Hereditary diffuse gastric cancer is a rare but devastating genetic condition caused by a mutation that inactivates the cell to cell adhesion molecule E-cadherin. Those with this mutation have a 70% chance of developing
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