RT Journal Article SR Electronic T1 Does hiatal hernia impact gastroesophageal reflux-related chronic cough? JF ERJ Open Research JO erjor FD European Respiratory Society SP 00669-2022 DO 10.1183/23120541.00669-2022 A1 Truba, Olga A1 Żuchowska, Joanna A1 Grabczak, Elżbieta M A1 Białek-Gosk, Katarzyna A1 Rybka-Frączek, Aleksandra A1 Krenke, Rafał A1 Dąbrowska, Marta YR 2023 UL http://openres.ersjournals.com/content/early/2023/01/26/23120541.00669-2022.abstract AB Hiatal hernia (HH) may coexist with gastroesophageal reflux-related chronic cough (GER, CC). The study aimed to evaluate whether the presence of HH was related to CC severity and the response to anti-reflux therapy. This was a retrospective analysis of data on adults with GER-related CC managed in our cough center between 2017 and 2021. Patients who had undergone chest CT and in whom follow up data were available were included. The presence and size of HH were assessed based on thorax CT scanning. Patients were treated with modification of diet and proton pump inhibitors. The response to treatment was assessed by the change in quality of life (QOL) measured by Leicester Cough Questionnaire (LCQ) and cough severity was measured by 100 mm Visual Analogue Scale (VAS). Forty five adults (28 F, 17 M) were included. HH was demonstrated in 12 patients (26.6%). Patients with HH did not differ from those without HH in clinical characteristics, cough duration and severity, and cough-related QOL. We found moderate positive correlations between maximal sagittal diameter of HH and cough severity (rho=0.692, p=0.013) and duration (rho=0.720, p=0.008). Patients without HH responded better to anti-reflux therapy with significant LCQ improvement. A strong negative correlation between sagittal diameter of HH gate and increase in LCQ (rho=-0.764, p=0.004) was demonstrated. The presence of HH identified in chest CT may impact cough severity, duration and response to anti-reflux treatment in patients with GER-related CC. Further prospective studies are justified to confirm significance of HH in the management of CC.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: We declare that MD has received fees from Merck for consultations and lectures on chronic cough, outside the submitted work. EMG has received honorary for lectures on chronic cough from Merck and Polpharma, outside the submitted work. ARF has received fee from Polpharma for attendance at ERS International Congress (2019), outside the submitted work. RK has received honorary for lectures from Chiesi, AstraZeneca, Polpharma, outside the submitted work; Boehringer Ingelheim, Chiesi and AstraZeneca have covered his fee and travel expenses for ERS International Congresses (2018, 2019) and ATS Conferences (2018, 2019), outside the submitted work.Conflict of interest: OT, JZ and KBG declare no conflict of interest.Conflict of interest: The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the study apart from those disclosed.