Acid Reflux May Trigger Chronic Croup

Although croup is usually not a serious condition, it can be scary for both children and parents. It most commonly affects children between the ages of six months and three years, and is most likely to occur during the fall, winter and early spring. Most croup is thought to be caused by the same virus that causes the common cold, but similar symptoms may sometimes be caused by bacteria or an allergic reaction.

Croup is characterized by a loud, repetitive barking cough that may be accompanied by labored or fast breathing and sometimes a harsh wheezing noise when breathing in. These symptoms are the result of swelling around the vocal cords (larynx) and windpipe (trachea). It is known that some children are prone to developing croup, especially those who were born prematurely, those with narrowed upper airways, and babies with a history of breathing problems like asthma. However, some children who experience recurrent bouts of croup may be suffering from another condition as well—gastroesophageal reflux disease.

Researchers at the University of Utah evaluated the airways of 80 children with recurrent croup using a tiny camera attached to a long, thin tube. They found that 33 percent of the children had narrowing of the airway, and 19 of those (73 percent) children had gastroesophageal reflux disease. After receiving treatment for their reflux disease for one year, 14 of the 19 showed improvement in croup.
 

Lead researcher, Dr. Harlan R. Muntz, a professor of pediatric otolaryngology, explained that in gastroesophageal reflux disease, stomach acid causes swelling and inflammation of the larynx, which narrows the airway. “More importantly, it can trigger more swelling with any kind of viral or respiratory infection.”

While some experts feel these new study findings may apply to just a small number of croup patients, Dr. Muntz thinks that many episodes of croup could be averted if children with gastroesophageal reflux disease were identified and proper preventive treatment could be prescribed. He said it’s unusual for a child to have three or more bouts of croup over a short period of time. “These children need to be evaluated to make sure we know what’s happening, and if they have reflux that that’s treated to help reduce the frequency and severity of the episodes of croup.”

The study findings were presented on September 21 in Chicago at the American Academy of Otolaryngology—Head and Neck Surgery Foundation annual meeting.