Diagnostic pathways for gastroesophageal reflux cough: From empirical recognition to MII-pH-based multidimensional assessment
- 1Laboratory of Cough, Affiliated Kunshan Hospital of Jiangsu University, Kunshan Key Laboratory of Chronic Cough, Suzhou, China
- 2Department of Respiratory Medicine, Zhongda Hospital, Southeast University, Nanjing, China
- 3Department of Respiratory Medicine, Taizhou Second People’s Hospital Affiliated to Yangzhou University, Taizhou, China
Abstract
Background: Gastroesophageal reflux cough (GERC) is recognized as one of the leading etiologies of chronic cough. However, traditional diagnostic modalities suffer from exceptionally high misdiagnosis rates. This situation frequently puts clinicians in a dilemma of relying on empirical therapeutic trials.
Methods: Integrated with the 2024 Lyon Consensus 2.0, this review aims to explore the crucial value of 24-hour multichannel intraluminal impedance-pH (MII-pH) monitoring in the precision diagnosis of GERC.
Main findings: This review first clarifies the fundamental role of exclusionary broad-spectrum screening and non-invasive initial assessments in early clinical triage. Then, it provides a deep analysis of the dual physical-chemical monitoring theories of MII-pH, systematically explains the four main index of this inspection method. Furthermore, by integrating High-Resolution Manometry (HRM) and oropharyngeal pH monitoring (Restech), this review to construct an individualized, stepwise clinical diagnostic pathway. In the end, this review lists the limitation of MII-pH,provokes the future outlook.
Conclusions: MII-pH monitoring plays a critical role in the diagnosis of GERC. It provides assessment of reflux events and reflux-cough associations. Combined with other diagnostic tools, it improves the diagnostic accuracy and provides support for clinical decision making. Despite its limitations, in the future, with the development of technology, MII-pH shall be more valuable in the diagnosis of GERC.
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BibTeX
@article{liu2026diagnostic,
title = {{Diagnostic pathways for gastroesophageal reflux cough: From empirical recognition to MII-pH-based multidimensional assessment}},
author = {Chang Liu and Qun Wang and Lei Pan and Changwen Chen and Gaoyan Zhai and Qiufang Shen and Jiahua Pan and Zhe Chen and Hong Zhu},
journal = {Therapeutic Advances in Respiratory Disease},
year = {2026},
month = sep,
doi = {10.1177/17534666261486681},
url = {https://doi.org/10.1177/17534666261486681},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Diagnostic pathways for gastroesophageal reflux cough: From empirical recognition to MII-pH-based multidimensional assessment
AU - Chang Liu
AU - Qun Wang
AU - Lei Pan
AU - Changwen Chen
AU - Gaoyan Zhai
AU - Qiufang Shen
AU - Jiahua Pan
AU - Zhe Chen
AU - Hong Zhu
PY - 2026
DA - 2026/09/16
JO - Therapeutic Advances in Respiratory Disease
DO - 10.1177/17534666261486681
UR - https://doi.org/10.1177/17534666261486681
AB - Background: Gastroesophageal reflux cough (GERC) is recognized as one of the leading etiologies of chronic cough. However, traditional diagnostic modalities suffer from exceptionally high misdiagnosis rates. This situation frequently puts clinicians in a dilemma of relying on empirical therapeutic trials. Methods: Integrated with the 2024 Lyon Consensus 2.0, this review aims to explore the crucial value of 24-hour multichannel intraluminal impedance-pH (MII-pH) monitoring in the precision diagnosis of GERC. Main findings: This review first clarifies the fundamental role of exclusionary broad-spectrum screening and non-invasive initial assessments in early clinical triage. Then, it provides a deep analysis of the dual physical-chemical monitoring theories of MII-pH, systematically explains the four main index of this inspection method. Furthermore, by integrating High-Resolution Manometry (HRM) and oropharyngeal pH monitoring (Restech), this review to construct an individualized, stepwise clinical diagnostic pathway. In the end, this review lists the limitation of MII-pH,provokes the future outlook. Conclusions: MII-pH monitoring plays a critical role in the diagnosis of GERC. It provides assessment of reflux events and reflux-cough associations. Combined with other diagnostic tools, it improves the diagnostic accuracy and provides support for clinical decision making. Despite its limitations, in the future, with the development of technology, MII-pH shall be more valuable in the diagnosis of GERC.
SN - 1753-4658
SN - 1753-4666
ER -