Silent Gastroesophageal Reflux Disease Presenting With Acute Cough and Poor Response to Antitussives: A Case Report
Abstract
Silent gastroesophageal reflux disease (GERD) is an atypical form of reflux disease in which patients present predominantly with extra-esophageal manifestations rather than classic symptoms such as heartburn or acid regurgitation. In this form, gastric refluxate may reach the upper aerodigestive tract, leading to laryngeal or respiratory symptoms that are frequently misattributed to infectious or allergic conditions. The absence of typical gastrointestinal complaints often results in delayed diagnosis and repeated ineffective treatments. We report the case of a 27-year-old male who presented with acute dry cough and progressive hoarseness without gastrointestinal symptoms. After excluding infectious and allergic etiologies, and noting a poor response to antitussive and bronchodilator therapies, a presumptive clinical diagnosis was established. Recognition of dietary triggers and rapid symptom resolution following a 4-week empirical trial of proton pump inhibitor therapy-along with symptom recurrence upon temporary discontinuation-supported the diagnosis of silent GERD. This case highlights the importance of considering reflux-related etiologies in patients with unexplained cough and laryngeal symptoms to avoid diagnostic delays and unnecessary empirical treatments.
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Advantages and Disadvantages of Long-term Proton Pump Inhibitor Use
- Ivth brazilian consensus conference on helicobacter pylori infection
- A pSMAD/CDX2 complex is essential for the intestinalization of epithelial metaplasia
- S2k-Leitlinie Gastroösophageale Refluxkrankheit und eosinophile Ösophagitis der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) – März 2023 – AWMF-Registernummer: 021–013
- Step-by-step management of refractory gastresophageal reflux disease
- Insights into Effects/Risks of Chronic Hypergastrinemia and Lifelong PPI Treatment in Man Based on Studies of Patients with Zollinger–Ellison Syndrome
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.