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Persistent cough: A question for the gastroenterologist?
  1. Elizabeth Parsons1,
  2. Bronwen E Warner1,
  3. Barbara Braden2
  1. 1Acute General Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
  2. 2Department of Gastroenterology, Oxford University Hospitals NHS Trust, Oxford, UK
  1. Correspondence to Dr Bronwen E Warner, Oxford University Hospitals NHS Trust, Headley Way, Headington, OX3 9DU, UK; bronwenewarner{at}gmail.com

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Case

An 80-year-old female retired teacher was admitted under the medical team with right-lower-lobe pneumonia.

The patient, a non-smoker with minimal alcohol intake, had a medical history of non-Hodgkin’s lymphoma treated with radiotherapy and splenectomy 30 years before, Barrett’s oesophagus (C9M9 Prague Classification) with distal oesophageal ulcer diagnosed 8 months previously, hiatus hernia and dual-chamber pacemaker for sinus-arrest. Medications were omeprazole 80 mg and ranitidine 300 mg daily.

During the preceding two years, the patient had consulted Respiratory and Gastroenterology teams for a persistent cough worsened by eating and drinking and two stone weight loss (admission BMI 16). High-resolution CT demonstrated subsegmental atelectasis and ground glass changes in …

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