The Treatment of Chronic Cough by Osteopathy: A Case Study of a Patient with Refractory Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD) occurs when acid or other stomach contents back up in the esophagus. The most common symptom of GERD is heartburn, which, while rarely life-threatening, can greatly reduce a patient’s quality of life by affecting daily activities, sleep and what they can eat [1,2]. A systematic review found the prevalence of GERD to be 1020% of the Western world with a lower prevalence in Asia [3,4]. Typically, the diagnosis of GERD is based on heartburn and acid regurgitation; however, research findings suggest that extraesophageal signs and symptoms are frequent in clinical practice. Clinically troublesome heartburn is seen in about 6% of the population. Chronic cough, asthma, chronic laryngitis, other airway symptoms and so-called extraesophageal symptoms are called atypical reflux. Studies have identified that one of the common clinical manifestations of atypical GERD is chronic cough [5]. There are reports of refractoriness when, in the treatment of GERD, the patient remains symptomatic even when using medication and this is very common in atypical GERD [4]. In some cases the treatment of this disease has a high cost and the patient may present side effects due to the treatment [4-6].