Cough and reflux esophagitis in children: their co-existence and airway cellularity

Chang, Anne B., Cox, Nancy C., Faoagali, Joan, Cleghorn, Geoffrey J., Beem, Christopher, Ee, Looi C., Withers, Geoffrey D., Patrick, Mark K. and Lewindon, Peter J. (2006) Cough and reflux esophagitis in children: their co-existence and airway cellularity. BMC Pediatrics, 6 4: 1-8. doi:10.1186/1471-2431-6-4

Author Chang, Anne B.
Cox, Nancy C.
Faoagali, Joan
Cleghorn, Geoffrey J.
Beem, Christopher
Ee, Looi C.
Withers, Geoffrey D.
Patrick, Mark K.
Lewindon, Peter J.
Title Cough and reflux esophagitis in children: their co-existence and airway cellularity
Journal name BMC Pediatrics   Check publisher's open access policy
ISSN 1471-2431
Publication date 2006
Sub-type Article (original research)
DOI 10.1186/1471-2431-6-4
Open Access Status DOI
Volume 6
Issue 4
Start page 1
End page 8
Total pages 8
Editor F. Godlee
Place of publication London, U.K.
Publisher BioMed Central
Collection year 2006
Language eng
Subject C1
321019 Paediatrics
730110 Respiratory system and diseases (incl. asthma)
Formatted abstract
There are no prospective studies that have examined for chronic cough in children without lung disease but with gastroesophageal reflux (GER). In otherwise healthy children undergoing flexible upper gastrointestinal endoscopy (esophago-gastroscopy), the aims of the study were to (1) define the frequency of cough in relation to symptoms of GER, (2) examine if children with cough and reflux esophagitis (RE) have different airway cellularity and microbiology in bronchoalveolar lavage (BAL) when compared to those without.


Data specific for chronic cough (>4-weeks), symptoms of GER and cough severity were collected. Children aged <16-years (n = 150) were defined as 'coughers' (C+) if a history of cough in association with their GER symptoms was elicited before BAL were obtained during elective esophago-gastroscopy. Presence of esophagitis on esophageal biopsies was considered reflux esophagitis positive (E+).


C+ (n = 69) were just as likely as C- (n = 81) to have esophagitis, odds ratio 0.87 (95%CI 0.46, 1.7). Median neutrophil percentage in BAL was significantly different between groups; highest in C+E- (7, IQR 28) and lowest in C-E+ (5, IQR 6). BAL positive bacterial culture occurred in 20.7% and were more likely present in current coughers (OR 3.37, 95%CI 1.39, 8.08). Airway neutrophilia (median 20%, IQR 34) was significantly higher in those with BAL positive bacterial cultures than those without (5%, 4; p = 0.0001).


In children without lung disease, the common co-existence of cough with symptoms of GER is independent of the occurrence of esophagitis. Airway neutrophilia when present in these children is more likely to be related to airway bacterial infection and not to esophagitis.
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
2007 Higher Education Research Data Collection
School of Medicine Publications
Version Filter Type
Citation counts: Scopus Citation Count Cited 25 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Wed, 15 Aug 2007, 08:02:39 EST