[Chronic cough and gastroesophageal reflux in children].
Gastroesophageal reflux (GER) is one of the three most common causes of chronic cough in children, along with postnasal drip syndrome and asthma. There may be no gastrointestinal symptoms up to 50-75% of the time. GER plays a causative role in chronic cough, asthma without allergy and posterior laryngitis. GER most commonly provokes coughing by stimulating an esophageal-bronchial reflex and by irritating the lower respiratory tract by microaspiration. Twenty-four-hour pH monitoring of the distal esophagus is the most accurate diagnostic method for children with suspected GER and it helps to establish a temporal correlation between cough and GER. The first step of the treatment is the association of postural and dietetic measures and medications (prokinetics and antacids). The length of the treatment is a minimum of 3 months up to the age of walking. Surgical treatment must be reserved for the failure of medical treatment. The benefits of minimally invasive surgery are evident in children with chronic cough, who have a faster recovery with fewer complication than after open surgery.
Juchet
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A
Service des maladies respiratoires et allergiques de l'enfant et de l'adolescent, hôpital Purpan, 31059 Toulouse, France.
Brémont
F
F
Dutau
G
G
Olives
J P
JP
D000293:Adolescent; D000367:Age Factors; D000863:Antacids / Q000627:therapeutic use; D001249:Asthma / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003371:Cough / Q000209:etiology* / Q000503:physiopathology; D003937:Diagnosis, Differential; D005745:Gastric Acidity Determination; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019060:Minimally Invasive Surgical Procedures
D000863:Antacids