Figure 1.

Management pathway for the clinical protocol. Figure legend: Initial empirical treatment for reflux related cough was acid suppressive therapy (lansoprazole 30 mg bd with ranitidine 300 mg on). If this did not lead to amelioration of symptoms and airway reflux was thought to be the cause, sequentially pro-kinetics (metoclopramide 10 mg tds / domperidone 10 mg tds) and baclofen (5 mg tds and increased to 10 mg tds depending upon response / tolerance) trials were instituted prior to transfer to sequential trials or the investigational protocol. The initial treatment for asthma and related disorders was with a high dose inhaled cortico-steroid and long acting beta2 agonist combination inhaler. Subsequent additional therapy was with montelukast (10 mg od). The treatment for rhinitis was with an inhaled nasal cortico-steroid with the addition of anti-histamine as additional therapy.