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Severity of acid gastroesophageal reflux assessed by pH metry: is it associated with respiratory disease?

Arkadi Gorenstein1, Arie Levine, Mona Boaz

  • 1Department of Pediatric Surgery, Edith Wolfson Medical Center, Holon 58100, Israel.

Pediatric Pulmonology
|September 2, 2003
PubMed

Insights

In children with chronic respiratory diseases and silent gastroesophageal reflux (GER), longer esophageal clearance, not reflux severity, is linked to respiratory issues. This finding is crucial for understanding pediatric GER and respiratory disease connections.

Area of Science:

  • Pediatric Gastroenterology
  • Pulmonology
  • Gastroesophageal Reflux Disease

Background:

  • Gastroesophageal reflux (GER) is common in children with chronic respiratory diseases (RD), often presenting silently.
  • The relationship between the severity of GER and the presence of RD in children requires further investigation.

Purpose of the Study:

  • To determine if chronic respiratory diseases in pediatric patients with silent GER correlate with more severe acid reflux.
  • To compare reflux parameters in children with RD and silent GER versus those with symptomatic GER, with or without RD.

Main Methods:

  • A study involving 236 children (1 month to 15 years) with abnormal 24-hr pH monitoring for GER diagnosis.
  • Patients were categorized into three groups: chronic RD with silent GER, symptomatic GER without RD, and concurrent RD and symptomatic GER.
  • Analysis of pH monitoring parameters including fraction of time with pH <4, total time with pH <4, longest episode with pH <4, and esophageal clearance time.

Main Results:

  • Children with symptomatic GER (with or without RD) showed significantly higher reflux severity (higher fraction of time and total time with pH <4).
  • Esophageal clearance was significantly longer in children with chronic RD and silent GER compared to those with symptomatic GER.
  • Longer esophageal clearance was the sole parameter associated with respiratory symptoms in patients with respiratory conditions.

Conclusions:

  • In pediatric patients with silent GER, the presence of chronic respiratory disease is associated with prolonged esophageal clearance, not increased acid reflux severity.
  • These findings suggest that impaired esophageal clearance, rather than severe reflux, may be a key factor linking GER and respiratory symptoms in children.

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