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Most Chronic Coughs in Kids From Allergy, Asthma or Reflux

Last Updated: September 10, 2009.

The great majority of chronic coughs without obvious cause among pediatric patients are from allergies, asthma or gastroesophageal reflux disease, according to a study in the Sept. 1 issue of Chest.

THURSDAY, Sept. 10 (HealthDay News) -- The great majority of chronic coughs without obvious cause among pediatric patients are from allergies, asthma or gastroesophageal reflux disease, according to a study in the Sept. 1 issue of Chest.

Vikram Khoshoo, M.D., of the West Jefferson Medical Center in New Orleans, and colleagues evaluated 40 children (5 to 12 years of age) who had had visited a primary care physician for a chronic cough that had persisted for more than eight weeks. The patients were thoroughly examined and tested, including pulmonary, allergy, immunology, gastrointestinal and otorhinolaryngology testing, and were then treated as indicated. Treatment response was assessed after eight weeks.

The researchers found that comprehensive examination and testing reached a positive diagnosis in the great majority of coughs, with 82.5 percent caused by gastroesophageal reflux disease, allergy or asthma. Other minor causes were infection and aspiration. When suitable treatment was used there was a significant improvement in the cough. The authors further note that the current treatment recommendation of the American College of Chest Physicians of antibiotics for pediatric cough is "problematic".

"It is essential to know the common etiologies of chronic cough in order to establish an appropriate differential diagnosis and to make treatment and referral decisions. With this heightened awareness about the potential causative factors, the primary care physicians can direct history taking, physical examinations, investigations, and treatment more efficiently," Khoshoo and colleagues conclude.

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