TY - JOUR
T1 - Weakly acidic gastroesophageal refluxes are frequently triggers in young children with chronic cough
AU - Ghezzi, Michele
AU - Guida, Edoardo
AU - Ullmann, Nicola
AU - Sacco, Oliviero
AU - Mattioli, Girolamo
AU - Jasonni, Vincenzo
AU - Rossi, Giovanni A.
AU - Silvestri, Michela
PY - 2013/3
Y1 - 2013/3
N2 - Objective To evaluate whether the proportion of acid and weakly acidic refluxes preceding cough bursts could be different in infants, preschool- and school-aged children with chronic, unexplained cough. Patients and Methods One hundred six children with unexplained chronic cough, not receiving acid suppressive therapy, underwent impedance-pH monitoring. They were divided into Group A: 6 years (44 pts). Reflux was defined as acid (pH 7).Cough episodes were considered temporally associated with gastroesophageal reflux (GER) when occurring within 2 min after a GER episode. Results Impedance-pH detected 55.50 (39.00-76.00) reflux episodes/patient with an acid-to-WA reflux event ratio of 3.31 (1.55-8.33). This parameter was significantly lower in Group A (1.33 [0.41-3.40]) than in Group B (3.06 [2.00-6.50]; P <0.05] and Group C (5.09 [2.34-12.43; P <0.001]). No cough episode was preceded by weakly alkaline refluxes in any patient. During impedance-pH recording, 93 patients (87.7%) had at least one cough episode that had been preceded by impedance refluxes in 83 patients. In this latter group (83 pts), the median number of cough episodes was 12.0 (5.0-25.5), of which 48.15% (30.15-71.43%) were preceded by refluxes; GER-preceded cough episodes were similar in the three groups. The majority of children had cough episodes preceded by acid refluxes in the total population (78.3%), in Group B (80.5%) and in Group C (93.7%), but not in Group A (40.0%; P <0.001). Conclusions In addition to acid, also a significant proportion of WA GER may precede cough episodes in young children with persistent cough, possibly explaining the inconstant effects of anti-acid treatment on respiratory symptoms. Pediatr Pulmonol. 2013; 48:295-302. © 2012 Wiley Periodicals, Inc.
AB - Objective To evaluate whether the proportion of acid and weakly acidic refluxes preceding cough bursts could be different in infants, preschool- and school-aged children with chronic, unexplained cough. Patients and Methods One hundred six children with unexplained chronic cough, not receiving acid suppressive therapy, underwent impedance-pH monitoring. They were divided into Group A: 6 years (44 pts). Reflux was defined as acid (pH 7).Cough episodes were considered temporally associated with gastroesophageal reflux (GER) when occurring within 2 min after a GER episode. Results Impedance-pH detected 55.50 (39.00-76.00) reflux episodes/patient with an acid-to-WA reflux event ratio of 3.31 (1.55-8.33). This parameter was significantly lower in Group A (1.33 [0.41-3.40]) than in Group B (3.06 [2.00-6.50]; P <0.05] and Group C (5.09 [2.34-12.43; P <0.001]). No cough episode was preceded by weakly alkaline refluxes in any patient. During impedance-pH recording, 93 patients (87.7%) had at least one cough episode that had been preceded by impedance refluxes in 83 patients. In this latter group (83 pts), the median number of cough episodes was 12.0 (5.0-25.5), of which 48.15% (30.15-71.43%) were preceded by refluxes; GER-preceded cough episodes were similar in the three groups. The majority of children had cough episodes preceded by acid refluxes in the total population (78.3%), in Group B (80.5%) and in Group C (93.7%), but not in Group A (40.0%; P <0.001). Conclusions In addition to acid, also a significant proportion of WA GER may precede cough episodes in young children with persistent cough, possibly explaining the inconstant effects of anti-acid treatment on respiratory symptoms. Pediatr Pulmonol. 2013; 48:295-302. © 2012 Wiley Periodicals, Inc.
KW - impedance-pH recording
KW - infants
KW - preschool children
KW - school-aged children
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U2 - 10.1002/ppul.22581
DO - 10.1002/ppul.22581
M3 - Article
C2 - 22553136
AN - SCOPUS:84874111118
VL - 48
SP - 295
EP - 302
JO - Pediatric Pulmonology
JF - Pediatric Pulmonology
SN - 8755-6863
IS - 3
ER -