Irritable oesophagus syndrome as cause of chronic cough

Area of Science:

• Pediatrics
• Gastroenterology
• Respiratory Medicine

Background:

• Chronic cough in infants often presents diagnostic challenges.
• Common etiologies for persistent cough in infants include infections, asthma, and congenital anomalies.
• Gastro-oesophageal reflux is a potential, though less frequently identified, cause of chronic cough in this age group.

Observation:

• A case study of an infant presenting with chronic cough is detailed.
• Standard investigations for frequent causes of chronic cough were performed and yielded negative results.
• Continuous 24-hour oesophageal pH monitoring revealed a strong association between episodes of gastro-oesophageal reflux and the occurrence of cough attacks.

Findings:

• The infant's chronic cough demonstrated a direct correlation with documented gastro-oesophageal reflux events.
• Pharmacological intervention with cisapride, administered at 0.3 mg/kg three times daily, resulted in the successful resolution of the cough.
• The clinical presentation and response to treatment support irritable oesophagus syndrome as a causative factor.

Implications:

• This case highlights the importance of considering gastro-oesophageal reflux disease (GERD) in the differential diagnosis of unexplained chronic cough in infants.
• Irritable oesophagus syndrome, a manifestation of GERD, should be recognized as a potential etiology for persistent cough in pediatric patients.
• Oesophageal pH monitoring can be a valuable diagnostic tool for identifying reflux-associated cough when other causes are excluded.