A Cross-Sectional Study to Determine the Prevalence of Gastroesophageal Reflux in Children with Persistent Cough and Wheezing

Prevalence of Gastroesophageal Reflux in Children

  • Praveen P N Junior Consultant, Department of Pediatrics, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India
  • Kushvanth K N Senior Resident, Department of Pediatrics, St John Medical College, Bengaluru, Karnataka, India
  • Ashish Mallige Senior Resident, Department of Pediatrics, St John Medical College, Bengaluru, Karnataka, India
Keywords: Gastric Reflux, Cough, Asthma, Heart Burn


Background: Gastroesophageal reflux (GER) occurs in more than two-thirds of otherwise healthy infants and is the topic of discussion with pediatricians at one-quarter of all routine 6-month infant visits. GER is considered a normal physiologic process that occurs several times a day in healthy infants, children, and adults. GER is generally associated with transient relaxations of the lower esophageal sphincter independent  of swallowing, which permits gastric contents to enter the esophagus. The Objective to find out the prevalence of GER in children with cough and wheezing and its associated factors. Subjects and Methods: A cross-sectional study was done at A tertiary care hospital at the Institute of Naval Medicine, INHS, Mumbai from August 2016 to December 2017. A total of 30 study subjects Aged between the age of one to twelve years with persistent cough and wheezing lasting for more than three months despite treatment were included for the study. Results: The prevalence of gastroesophageal reflux (GER) in our study was 63.3%.The logistic regression analysis showed that Age, Height, Weight, BMI, duration of cough, Duration of asthma were not significantly associated with Gastroesophageal reflux (GER) (p>0.05). Conclusion: GER seems to have a high prevalence in children with chronic cough. However, no definite recommendations can be made regarding the management of such cases from our study.


Download data is not yet available.


Nelson SP, Chen EH, Syniar GM, Christoffel KK, Group PPR. Prevalence of symptoms of gastroesophageal reflux during childhood: a pediatric practice-based survey. Arch Pediatr Adolesc Med. 2000;154(2):150–154. Available from: https://doi.org/10.1001/archpedi.154.2.150.

Campanozzi A, Boccia G, Pensabene L, Panetta F, Marseglia A, Strisciuglio P, et al. Prevalence and Natural History of Gastroesophageal Reflux: Pediatric Prospective Survey. Pediat. 2009;123(3):779–783. Available from: https://dx.doi.org/10.1542/peds.2007-3569.

Shalaby TM, Orenstein SR. Efficacy of telephone teaching of conservative therapy for infants with symptomatic gastroe- sophageal reflux referred by pediatricians to pediatric gastroen- terologists. J Pediatr. 2003;142(1):57–61. Available from: https://dx.doi.org/10.1067/mpd.2003.mpd0331.

Vandenplas Y, Rudolph CD, Lorenzo D, C. Pediatric gas- troesophageal reflux clinical practice guidelines: joint recom- mendations of the North American Society for Pediatric Gas- troenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatol- ogy, and Nutrition (ESPGHAN). J Pediatr Gastroenterol Nutr. 2009;49(4):498–547.

Sherman PM, Hassall E, Fagundes-Neto U, Gold BD, Kato S, Koletzko S, et al. A Global, Evidence-Based Consensus on the Definition of Gastroesophageal Reflux Disease in the Pediatric Population. Am J Gastroenterol. 2009;104(5):1278–1295. Available from: https://dx.doi.org/10.1038/ajg.2009.129.

Shay S, Tutuian R, Sifrim D, Vela M, Wise J, Balaji N, et al. Twenty-Four Hour Ambulatory Simultaneous Impedance and pH Monitoring: A Multicenter Report of Normal Values From 60 Healthy Volunteers. Am J Gastroenterol. 2004;99(6):1037– 1043. Available from: https://dx.doi.org/10.1111/j.1572-0241.2004.04172.x.

Rudolph CD, Mazur LJ, Liptak GS. North American Society for Pediatric Gastroenterology and Nutrition. Guidelines for evaluation and treatment of gastroesophageal reflux in infants and children: recommendations of the North American Society for Pediatric Gastroenterology and Nutrition. J Pediatr Gastroenterol Nutr. 2001;32(2):1–31. Available from: https://doi.org/10.1097/00005176-200100002-00001.

Martin AJ, Pratt N, Kennedy JD, Ryan P, Ruffin RE, Miles H, et al. Natural History and Familial Relationships of Infant Spilling to 9 Years of Age. Pediatrics. 2002;109(6):1061–1067. Available from: https://dx.doi.org/10.1542/peds.109.6.1061.

Shepherd R, Wren J, Evan S, Lander M, Ong T. Gastroe- sophageal reflux in children. Clinical profile, course and out- come with active therapy in 126 cases. Clinical Pediatrics. 1987;26(2):55–60. Available from: https://dx.doi.org/10.1177/000992288702600201.

Deal L, Gold BD, Gremse DA, Winter HS, Peters SB, Fraga PD, et al. Age-Specific Questionnaires Distinguish

GERD Symptom Frequency and Severity in Infants and Young Children: Development and Initial Validation. J Pediatr Gastroenterol Nutr. 2005;41(2):178–185. Available from: https://dx.doi.org/10.1097/01.mpg.0000172885.77795.0f.

Shobna J, & D Nageshwar Reddy & Uday CB. Ghoshal et al Epidemiology and symptom profile of gastroe- sophageal reflux in the Indian population: report of the Indian Society of Gastroenterology Task Force. Indian J Gastroen- terol. 2011;30(3):118–127. Available from: https://doi.org/10.1007/s12664-011-0112-x.

Størdal K, Johannesdottir GB, Bentsen BS, Sandvik L. Gas- troesophageal reflux disease in children: Association between symptoms and pH monitoring. Scand J Gastroenterol. 2005;40(6):636–640. Available from: https://dx.doi.org/10.1080/00365520510015502.

Poe RH, Harder RV, Israel RH, Kallay MC. Chronic persistent cough. Experience in diagnosis and outcome using an anatomic diagnostic protocol. Chest. 1989;95(4):723–751. Available from: https://doi.org/10.1378/chest.95.4.723.

Irwin RS, Corrao WM, Pratter MR. Chronic persistent cough: the spectrum and frequency of causes and successful outcome of specific therapy. Am Rev Respir Dis. 1981;123(4):413–430. Available from: https://doi.org/10.1164/arrd.1981.123.4.413.

Shirahata K, Fujimoto K, Arioka H, Shouda R, Kudo K, ichi Ikeda S. Prevalence and clinical features of cough variant asthma in a general internal medicine outpatient clinic in Japan. Respirology. 2005;10(3):354–358. Available from: https://dx.doi.org/10.1111/j.1440-1843.2005.00709.x.

Othman S. Saleh Othman Gastroesophageal reflux studies using milk in infants and children - the need for multiple views Nuclear Medicine Communications; 2011. Available from: https://doi.org/10.1097/mnm.0b013e32834a0b0d.

Khoshoo V, Edell D, Mohnot S, Haydel R, Saturno E, Kobernick A. Associated Factors in Children With Chronic Cough. Chest. 2009;136(3):811–815. Available from: https://dx.doi.org/10.1378/chest.09-0649.

Said M, Syamsu R, Tambunan T, Hegar B. Gastroesophageal reflux in children with chronic recurrent cough. Paediatrica Indonesiana. 2004;44(5):1–10. Available from: https://doi.org/10.14238/pi44.5.2004.201-5.

How to Cite
Praveen P N, Kushvanth K N, & Ashish Mallige. (2020). A Cross-Sectional Study to Determine the Prevalence of Gastroesophageal Reflux in Children with Persistent Cough and Wheezing. Asian Journal of Clinical Pediatrics and Neonatology, 8(4), 36-40. https://doi.org/10.47009/ajcpn.2020.8.4.8
Original Article