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[Variations of nasopharyngeal pH in nasopharyngitis in children]
P Contencin1, P Viala, P Narcy
1Service ORL, Hôpital Robert-Debré, Paris.
Insights
Gastro-oesophageal reflux (GOR) may cause chronic rhinopharyngitis in children. Acid reflux was detected in the pharynx of children with this condition, suggesting a link between stomach acid and upper airway inflammation.
Area of Science:
- Otolaryngology
- Gastroenterology
- Pediatrics
Context:
- Gastro-oesophageal reflux (GOR) is linked to lower airway inflammation.
- Chronic inflammatory rhinopharyngitis in children often lacks a clear cause.
- The potential for acid reflux to reach the pharynx has been hypothesized but not proven.
Purpose:
- To investigate the hypothesis that gastric acid contaminates the rhinopharynx.
- To measure pharyngeal pH in children with chronic rhinopharyngitis and GOR.
- To compare pharyngeal pH in patients versus control groups.
Summary:
- Nycthemeral (24-hour) local pH was monitored in 18 children with chronic rhinopharyngitis and GOR, and in control groups.
- Patients exhibited more frequent and prolonged drops in rhinopharyngeal pH (below 6) compared to controls.
- Findings suggest that GOR is the likely source of pharyngeal acidity.
Impact:
- Acidic conditions in the pharynx may contribute to the development or persistence of nasopharyngeal inflammation.
- This study provides evidence for a connection between GOR and pediatric upper airway inflammatory conditions.
- Further research is needed to confirm these hypotheses and elucidate the mechanisms involved.
Abstract:
In view of the well-known relationship between gastro-oesophageal reflux (GOR) and inflammatory diseases of the bronchi, trachea and larynx, the possibility of a pathogenic acid reflux reaching the pharynx has sometimes been suspected but never demonstrated. Paediatric E.N.T. specialists are often confronted with chronic inflammatory rhinopharyngitis of no obvious origin. In order to test the hypothesis of rhinopharyngeal contamination by gastric acid, the nycthemeral local pH was recorded in children presenting with chronic rhinopharyngitis and gastro-oesophageal reflux, and in two groups of controls without rhinopharyngitis and with or without GOR. Falls in rhinopharyngeal pH were found to be more frequent and to last longer in the 18 patients than in controls. The most significant criterion was the time during which the pH was lower than 6 compared with the total time of recording in these cases where pharyngeal pH measurements were recorded over 15 to 26 hours. It seemed most probable that this acidity resulted from the gastro-oesophageal reflux. Such variations in acid-base balance at the surface of a respiratory mucosa might be instrumental in the genesis or maintenance of the nasopharyngeal inflammatory reaction. However, these two hypotheses must be confirmed or infirmed by further studies.