In immunocompetent adults who have a normal or almost normal X-ray of the lungs, do not smoke and do not use angiotensin converting enzyme inhibitors, the most frequent causes of chronic cough are „postnasal drip syndrome“, asthma and gastrooesophageal reflux disease. By using a systematic anatomical diagnostic protocol the cause of chronic cough is found in 98–100% of cases and specific treatment focused on an identified cause is successful in 84–98% patients. Gastrooesophageal reflux alone or in combination with other diseases causes 7.7–40% of chronic cough. In as many as 75% cases of chronic cough associated with reflux disease cough may be the only symptom of gastrooesophageal reflux. In the pathogenesis of cough in reflux disease direct irritation of the larynx combines with microaspiration, macroaspiration and by acting on the reflex arc of cough by irritation of the vagal endings in the oesophageal mucosa. Suspicion of reflux disease as the cause of chronic cough develops in patients who have typical symptoms of reflux as well as in asymptomatic subjects where cough persists despite the fact that asthma or the „postnasal drip syndrome“ are ruled out or properly treated. The „gold standard“ in the diagnosis of chronic cough in reflux disease is 24-hour monitoring of the pH in the oesophagus which not only confirms and characterizes reflux but also makes it possible to provide evidence of a temporal relationship between reflux episodes and cough. If this method is not available, empirical treatment is recommended. In conservative procedures maximal and sufficiently long antireflux treatment proves useful, as cough can persist even after normalization of typical symptoms and conventional parameters of reflux. Indications for surgical treatment include in patients with chronic cough associated with reflux disease also cough resistant to conservative antireflux therapy.

        Key words: chronic cough – gastrooesophageal reflux