Recurrent Cough in children

6 years old male child came with complaints of repeated episodes of dry cough, no cold and no fever. No history of wheezy episodes or any need of nebulization, no history of allergies, tuberculosis in child and family. Weight 20 kgs, diet includes non-veg food 4 days a week, late dinner when dad comes home from office, 1lit or water intake per day. On examination also there was no abnormal findings, chest was clear and normal air entry on both side, though mild tenderness in epigastric region. Differential Diagnoses were Allergic bronchitis, tuberculosis, Gastro esophageal reflux induced cough. Blood tests were normal, no eosinophilia, Chest X-ray was normal, other Tuberculosis screen was negative. Child was started on antacid for 1 month and episodes decreased. Decrease in frequency of non-veg diet was advised, dinner timings were preponed, increased water intake. The repeat episodes of cough have gone down drastically on regular follow-up though child required antacid course for 3 months. DISCUSSION: Few of the diagnosis are diagnosis on exclusion; here the cough was leading us towards diagnosis of respiration system related disease, but when we ruled out possibilities of the same, it was required to think out of the box towards gastric etiological cause. Here because of hyperacidity, maybe due to high non-veg food intake, less water intake, lead to acid reflux in esophagus and it irritated the throat repeatedly to cause cough.

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