[Dysphagia] Cough

[eripley at yahoo.com (Irene Campbell-Taylor)]

   The client then went on to say that her 4 year old daughter 
still
drools and her own mother had commented that my client drooled for most
of her childhood.  
  *** Possibly familial form of GERD.

My questions to you are as follows.  Has anyone seen a similar
presentation?  (My understanding is that most people with diabetes have
a higher cough threshold) . Is there anything we could suggest apart
from smaller and more frequent meals to help her? Why is she coughing
with the bolus well into her esophagus?  Do you think it may be her
body's attempt to clear food by opening up her LES?  Or???
  See:
  Supraesophageal manifestations of gastroesophageal reflux disease.
   
  Semin Gastrointest Dis 1999 Jul;10(3):113-9
   
  Al-Sabbagh G; Wo JM 
   
  An increasing amount of evidence indicates that gastroesophageal reflux disease (GERD) is a contributing factor to hoarseness, throat clearing, throat discomfort, chronic cough, and shortness of breath. The association between GERD and these supraesophageal symptoms may be elusive. Heartburn and regurgitation are absent in more than 50% of patients. Acid reflux should be considered if signs of GERD are present, symptoms are unexplained, or symptoms are refractory to therapy. The diagnosis of GERD may be unclear, despite a careful history and initial evaluation. A high index of suspicion is required to make the diagnosis. An empiric trial of antireflux therapy is appropriate when GERD is suspected. Multiprobe ambulatory pH monitoring is currently the diagnostic test of choice, but the level of sensitivity and specificity for supraesophageal manifestations of GERD is uncertain. Response to antireflux therapy is less predictable than typical GERD. More intensive acid
 suppression and longer treatment duration are usually required.

 

Thank you for any insights you may have





Cindy Reynolds, M.H.Sc.,

Manager, Speech-Language Pathology

Lions Gate Hospital

Assistant Clinical Professor, UBC

604-984-5747

 





Dr I Campbell-Taylor
Clinical Neuroscientist
Exclusive Distributor:
www.interactivetherapy.com