Persistent cough: A question for the gastroenterologist?

An 80-year-old female retired teacher was admitted under the medical team with right-lower-lobe pneumonia. The patient, a non-smoker with minimal alcohol intake, had a medical history of non-Hodgkin’s lymphoma treated with radiotherapy and splenectomy 30 years before, Barrett’s oesophagus (C9M9 Prague Classification) with distal oesophageal ulcer diagnosed 8 months previously, hiatus hernia and dual-chamber pacemaker for sinus-arrest. Medications were omeprazole 80 mg and ranitidine 300 mg daily. During the preceding two years, the patient had consulted Respiratory and Gastroenterology teams for a persistent cough worsened by eating and drinking and two stone weight loss (admission BMI 16). High-resolution CT demonstrated subsegmental atelectasis and ground glass changes in …