- Title
- Chronic Cough and Gastroesophageal Reflux in Children: CHEST Guideline and Expert Panel Report
- Creator
- Chang, Anne B.; Oppenheimer, John J.; Barker, Alan F.; Bolser, Donald C.; Birring, Surinder S.; Braman, Sidney S.; Brightling, Christopher; Callahan-Lyon, Priscilla; Cowley, Terrie; Davenport, Paul; El Solh, Ali A.; Escalante, Patricio; Kahrilas, Peter J.; Field, Stephen K.; Fisher, Dina; French, CT; Grant, C; Gibson, Peter; Harding, SM; Gold, P; Harnden, A; Hill, AT; Kavanagh, J; Kantar, Ahmad; Lai, K; Lim, K; Madison, JM; Malesker, MA; Mazzone, S; McGarvey, L; Metlay, JP; Molasoitis, A; Murad, MH; Narasimhan, M; Rubin, Bruce K.; Newcombe, P; Oppenheimer, J; Rosen, M; Rubin, B; Russell, RJ; Ryu, JH; Singh, S; Smith, J; Smith, MP; Tarlo, SM; Weinberger, Miles; Turmel, J; Vertigan, AE; Irwin, Richard S.; Adams, Todd M.; Altman, Kenneth W.; Azoulay, Elie
- Relation
- Chest Vol. 156, Issue 1, p. 131-140
- Publisher Link
- http://dx.doi.org/10.1016/j.chest.2019.03.035
- Publisher
- American College of Chest Physicians
- Resource Type
- journal article
- Date
- 2019
- Description
- BACKGROUND:Whether gastroesophageal reflux (GER) or GER disease (GERD) causeschronic cough in children is controversial. Using the Population, Intervention, Comparison,Outcome (PICO) format, we undertook four systematic reviews. For children with chroniccough (>4-weeks duration) and without underlying lung disease: (1) who do not havegastrointestinal GER symptoms, should empirical treatment for GERD be used? (2) withgastrointestinal GER symptoms, does treatment for GERD resolve the cough? (3) with orwithout gastrointestinal GER symptoms, what GER-based therapies should be used and forhow long? (4) if GERD is suspected as the cause, what investigations and diagnostic criteriabest determine GERD as the cause of the cough?METHODS:We used the CHEST Expert Cough Panel’s protocol and American College ofChest Physicians (CHEST) methodological guidelines and GRADE (Grading of Recom-mendations Assessment, Development and Evaluation) framework. Delphi methodology wasused to obtain consensus.RESULTS:Few randomized controlled trials addressed thefirst two questions and noneaddressed the other two. The single meta-analysis (two randomized controlled trials)showed no significant difference between the groups (any intervention for GERDvs placebo for cough resolution; OR, 1.14; 95% CI, 0.45-2.93;P¼.78). Proton pumpinhibitors (vs placebo) caused increased serious adverse events. Qualitative data fromexisting CHEST cough systematic reviews were consistent with two international GERDguidelines.CONCLUSIONS:The panelists endorsed that: (1) treatment(s) for GERD should not be usedwhen there are no clinical features of GERD; and (2) pediatric GERD guidelines should beused to guide treatment and investigations.
- Subject
- children; cough; evidence-based medicine; gastroesophageal reflux
- Identifier
- http://hdl.handle.net/1959.13/1475246
- Identifier
- uon:49491
- Identifier
- ISSN:0012-3692
- Language
- eng
- Reviewed
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