Gastroesophageal reflux in children with chronic recurrent cough
Keywords:
gastroesophageal reflux, chronic cough, recurrent cough, asthma, children, prevalence, 24-hour esophageal monitoring
Abstract
Background Gastroesophageal reflux (GER) is reported to beone of the most common causes of chronic recurrent cough (CRC).
In Indonesia, so far there is no published data concerning GER in
children with CRC.
Objectives To determine the prevalence of GER in children with
CRC in general, and asthma in particular; and to describe the clini-
cal profile associated with GER in these children.
Methods This was a cross sectional study on children with CRC
who were investigated for GER using 24-hour esophageal pH
monitoring. GER was graded based on reflux index (RI) stated in
pHmetry results i.e., mild (RI=5-10%), moderate (RI>10-20%), and
severe (RI>20%).
Results Among 48 children with CRC, GER was detected in 22
(46%) of them (mild GER in 14, moderate in 3, and severe in 5
children). In 35 children with asthma, which is the most frequent
cause of CRC in our hospital, GER was detected in 15. The preva-
lence of GER increased parallel with the frequency of cough epi-
sodes i.e., 10/27 in children with infrequent episodes of cough, 4/
10 in children with frequent episodes of cough, and 8/11 in chil-
dren with persistent cough. Clinical profiles associated with GER
in these children were persistent/ frequent episodes of CRC and
undernutrition.
Conclusions The prevalence of GER in children with CRC was
46%, and in those with asthma was 15/35. The clinical profiles
associated with GER are persistent/frequent episodes of CRC
and undernutrition
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Vierucci A. Gastroesophageal reflux and bronchial asthma:
prevalence and effect of therapy. J Pediatr Gastroenterol
Nutr 1993;17:265-70.
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significant proximal esophageal acid reflux in infants pre-
senting with respiratory symptoms. Pediatr Pulmonol
1999;27:231-5.
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reflux in infants and children with chronic cough. Pediatr
Pulmonol 1999;28:181-6.
12. Hegar B, Firmansyah A. Diagnosis refluks gastroesofagus
pada anak. Maj Kedokt Indones 1999;49:71-5.
13. Gastal OL, Castell JA, Castell DO. Frequency and site of gastroe-
sophageal reflux in patients with chest symptoms: studies using
proximal and distal pH monitoring. Chest 1994;106:1793-6.
14. Vincent D, Cohen-Jonathan AM, Leport J, Merrouche
M, Geronimi A, Pradalier A, et al. Gastroesophageal
reflux prevalence and relationship with bronchial re-
activity in asthma. Eur Respir J 1997;10:2255-9.
15. Clark CL, Horwitz B. Complications of gastroesoph-
ageal reflux disease. Postgrad Med 1996;100:95-114.
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therapy for infants with symptomatic gastroesophageal
reflux referred by pediatricians to pediatric gastroen-
terologists. J Pediatr 2003;142:57-61.
children. Pediatr Pulmonol 1999;28:59-69.
2. Kastelik JA, Jackson W, Davies TW, Wright GA,
Redington AE, Wedgwood KR, et al. Measurement of
gastric emptying in gastroesophageal reflux-related
chronic cough. Chest 2002;122:2038-41.
3. Gorenstein A, Levine A, Boaz M, Mandelberg A,
Serour F. Severity of acid gastroesophageal reflux assessed
by pHmetry: is it associated with respiratory disease?
Pediatr Pulmonol 2003;36:330-4.
4. Sontag SJ, O’Connell S, Khandelwal S. Most asth-
matics have gastroesophageal reflux with or without
bronchodilator therapy. Gastroenterology 1990;
99:613-20.
5. Irwin RS, Curley FJ, French CL. Chronic cough: the
spectrum and frequency of causes, key components of
the diagnostic evaluation, and outcome of specific
therapy. Am Rev Respir Dis 1990;141:640-7.
6. Juchet A, Bremont F, Dutau G, Olives JP. Chronic cough
and gastroesophageal reflux in children. Arch de Pediatr
2001;8:629-34.
7. Jain A, Patwari AK, Bajaj P, Kashyap R, Anand VK. Asso-
ciation of gastroesophageal reflux disease in young children
with persistent respiratory symptoms. J Tropical Pediatr
2002;48:39-42.
8. Mahajan L, Wyllie R, Oliva L. Reproducibility of 24-hour
intraesophageal pH monitoring in pediatric patients. Pe-
diatrics 1998;101:260-3.
9. Tucci F, Resti M, Fontana R, Novembre E, Lami CA,
Vierucci A. Gastroesophageal reflux and bronchial asthma:
prevalence and effect of therapy. J Pediatr Gastroenterol
Nutr 1993;17:265-70.
10. Vijayaratnam V, Lin CH, Simpson P, Tolia V. Lack of
significant proximal esophageal acid reflux in infants pre-
senting with respiratory symptoms. Pediatr Pulmonol
1999;27:231-5.
11. Sheikh S, Stephen T, Howell L, Eid N. Gastroesophageal
reflux in infants and children with chronic cough. Pediatr
Pulmonol 1999;28:181-6.
12. Hegar B, Firmansyah A. Diagnosis refluks gastroesofagus
pada anak. Maj Kedokt Indones 1999;49:71-5.
13. Gastal OL, Castell JA, Castell DO. Frequency and site of gastroe-
sophageal reflux in patients with chest symptoms: studies using
proximal and distal pH monitoring. Chest 1994;106:1793-6.
14. Vincent D, Cohen-Jonathan AM, Leport J, Merrouche
M, Geronimi A, Pradalier A, et al. Gastroesophageal
reflux prevalence and relationship with bronchial re-
activity in asthma. Eur Respir J 1997;10:2255-9.
15. Clark CL, Horwitz B. Complications of gastroesoph-
ageal reflux disease. Postgrad Med 1996;100:95-114.
16. Shalaby TM, Orenstein SR. Efficacy of conservative
therapy for infants with symptomatic gastroesophageal
reflux referred by pediatricians to pediatric gastroen-
terologists. J Pediatr 2003;142:57-61.
Published
2016-10-10
How to Cite
1.
Said M, Syamsu R, Tambunan T, Hegar B. Gastroesophageal reflux in children with chronic recurrent cough. PI [Internet]. 10Oct.2016 [cited 25Apr.2024];44(5):201-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/778
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Received 2016-10-03
Accepted 2016-10-03
Published 2016-10-10
Accepted 2016-10-03
Published 2016-10-10
