Based on the high risk for recurrent episodes of bronchitis and/or pneumonia in EA-TEF, the RCWG strongly recommended that chronic wet cough should be evaluated for underlying undiagnosed anatomic and/or functional abnormalities. The main evaluation includes a CT scan to determine the presence of chronic changes such as bronchiectasis^47,50, and a BAL to determine presence of colonization with bacterial and other pathogens as well as for evidence of aspiration(see also section V for the evaluation of aspiration). The threshold for repeating the investigations should be low because there is evidence that airway inflammation, bacterial bronchitis, and bronchiectasis may be present in young children with EA/TEF even when they are asymptomatic^{9,45,65,107,108}. However, for patients with an established pattern it is not necessary to repeat the work-up for every exacerbation unless there is suspicion of new pathology. A CXR with each suspected episode of pneumonia may be useful to document how often a patient is having lobar pneumonia, which may, in turn, determine the necessity for further investigations.