An objective study of acid reflux and cough in children using an ambulatory pHmetry-cough logger

Chang, A. B., Connor, F. L., Petsky, H. L., Eastburn, M. M., Lewindon, P. J., Hall, C., Wilson, S. J. and Katelaris, P. H. (2011) An objective study of acid reflux and cough in children using an ambulatory pHmetry-cough logger. Archives of Disease in Childhood, 96 5: 468-472. doi:10.1136/adc.2009.177733

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Author Chang, A. B.
Connor, F. L.
Petsky, H. L.
Eastburn, M. M.
Lewindon, P. J.
Hall, C.
Wilson, S. J.
Katelaris, P. H.
Title An objective study of acid reflux and cough in children using an ambulatory pHmetry-cough logger
Journal name Archives of Disease in Childhood   Check publisher's open access policy
ISSN 0003-9888
Publication date 2011-05
Sub-type Article (original research)
DOI 10.1136/adc.2009.177733
Volume 96
Issue 5
Start page 468
End page 472
Total pages 5
Place of publication London, England, U.K.
Publisher B M J Group
Collection year 2012
Language eng
Formatted abstract
Objective There are no objective ambulatory studies on the temporal relationship between reflux and cough in children. Commercial pHmetry loggers have slow capture rates (0.25 Hz) that limit objective quantification of reflux and cough. The authors aimed to evaluate if there is a temporal association between cough and acid pH in ambulatory children with chronic cough.

Design, setting and patients
The authors studied children (aged <14 years) with chronic cough, suspected of acid reflux and considered for pHmetry using a specifically built ambulatory pHmetry–cough logger that enabled the simultaneous ambulatory recording of cough and pH with a fast (10 Hz) capture rate.

Main outcome measures
Coughs within (before and after) 10, 30, 60 and 120 s of a reflux episode (pH<4 for >0.5 s).

Results Analysis of 5628 coughs in 20 children. Most coughs (83.9%) were independent of a reflux event. Cough–reflux (median 19, IQR 3–45) and reflux–cough (24.5, 13–51) sequences were equally likely to occur within 120 s. Within the 10 and 30 s time frame, reflux–cough (10 s=median 2.5, IQR 0–7.25; 30 s=6.5, 1.25–22.25) sequences were significantly less frequent than reflux–no cough (10 s=27, IQR 15–65; 30 s=24.5, 14.5–55.5) sequences, (p=0.0001 and p=0.001, respectively). No differences were found for 60 and 120 s time frame. Cough–reflux sequence (median 1.0, IQR 0–8) within 10 s was significantly less (p=0.0001) than no cough–reflux sequences (median 29.5, 15–67), within 30 s (p=0.006) and 60 s (p=0.048) but not within 120 s (p=0.47).

In children with chronic cough and suspected of having gastro-oesophageal reflux disease, the temporal relationship between acid reflux and cough is unlikely causal.
Keyword Clinical-practice guidelines
Chronic unexplained cough
Acquired pneumonia
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

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