Inlet patch of gastric mucosa in upper esophagus causing chronic cough and vocal cord dysfunction

William S. Silvers, Joel S. Levine, Jill A. Poole, Erick Naar, Richard W. Weber

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: An inlet patch of gastric mucosa in the upper esophagus is usually an incidental, congenital finding found during upper gastrointestinal tract endoscopy. Although it has been reported to cause dysphagia, strictures, adenocarcinoma, and webs, it has never been associated with cough and vocal cord dysfunction. Objective: To report the first case of a patient with an inlet patch of gastric mucosa in the upper esophagus as the cause of a particularly troublesome, chronic cough that was initially missed on 2 upper endoscopies. Methods: The patient is a 50-year-old man with a 7-year history of chronic cough associated with hoarseness, shortness of breath, and globus sensation. For diagnostic evaluation, pulmonary function tests, chest computed tomography, rhinolaryngoscopy, upper gastrointestinal tract endoscopy, and histologic examinations were performed. Results: A multidisciplinary approach revealed several possible causes for the chronic cough, including vocal cord dysfunction, postnasal drip syndrome, allergic rhinitis, and mild gastroesophageal reflux disease that was only partially responsive to therapy. The results of 2 initial upper gastrointestinal tract endoscopies were interpreted as normal. A third endoscopy detected an inlet patch of gastric mucosa in the upper esophagus. Treatment with a high-dose histamine type 2 receptor antagonist and a proton pump inhibitor alleviated the patient's symptoms. Conclusions: An inlet patch of gastric mucosa in the upper esophagus is not uncommon, but it is often overlooked or believed to be an incidental, congenital finding. This is the first report, to our knowledge, of an inlet patch resulting in a troublesome, chronic cough.

Original languageEnglish (US)
Pages (from-to)112-115
Number of pages4
JournalAnnals of Allergy, Asthma and Immunology
Volume96
Issue number1
DOIs
StatePublished - Jan 2006

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Vocal Cord Dysfunction
Gastric Mucosa
Cough
Esophagus
Upper Gastrointestinal Tract
Gastrointestinal Endoscopy
Incidental Findings
Endoscopy
Histamine Receptors
Hoarseness
Proton Pump Inhibitors
Respiratory Function Tests
Deglutition Disorders
Gastroesophageal Reflux
Dyspnea
Pathologic Constriction
Adenocarcinoma
Thorax
Tomography
Therapeutics

ASJC Scopus subject areas

  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine

Cite this

Inlet patch of gastric mucosa in upper esophagus causing chronic cough and vocal cord dysfunction. / Silvers, William S.; Levine, Joel S.; Poole, Jill A.; Naar, Erick; Weber, Richard W.

In: Annals of Allergy, Asthma and Immunology, Vol. 96, No. 1, 01.2006, p. 112-115.

Research output: Contribution to journalArticle

Silvers, William S. ; Levine, Joel S. ; Poole, Jill A. ; Naar, Erick ; Weber, Richard W. / Inlet patch of gastric mucosa in upper esophagus causing chronic cough and vocal cord dysfunction. In: Annals of Allergy, Asthma and Immunology. 2006 ; Vol. 96, No. 1. pp. 112-115.
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