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Gastroesophageal reflux in children with chronic recurrent bronchopulmonary infection
1Department of Pediatrics, National Taiwan University Hospital, Taipei, Republic of China.
Insights
Gastroesophageal reflux (GER) is a potential cause of recurrent lung infections in children. 24-hour pH monitoring identified GER in most patients, and antireflux treatment improved symptoms, suggesting GER
Area of Science:
- Pediatrics
- Gastroenterology
- Pulmonology
Background:
- Recurrent bronchopulmonary infections in children can significantly impact health.
- Gastroesophageal reflux (GER) is a potential, yet often overlooked, contributing factor.
Purpose of the Study:
- To investigate the association between GER and recurrent bronchopulmonary infections in Chinese pediatric patients.
- To assess the diagnostic utility of 24-hour pH monitoring in identifying GER in this population.
Main Methods:
- Prospective study of 23 children (3-25 months) with recurrent bronchopulmonary infections.
- Utilized 24-hour esophageal pH monitoring to diagnose GER.
- Assessed outcomes following medical therapy and surgical intervention (fundoplication).
Main Results:
- Abnormal GER was detected in 21 out of 23 patients (91%).
- Medical therapy led to symptom improvement in 11 out of 17 patients (65%).
- Fundoplication resulted in marked improvement in 3 patients who did not respond to medical therapy.
Conclusions:
- GER is a significant contributing factor in pediatric recurrent bronchopulmonary infections.
- 24-hour pH monitoring is a reliable diagnostic tool for GER.
- Antireflux therapy, including fundoplication, can be beneficial for managing these conditions.
Abstract:
To evaluate the role of gastroesophageal reflux (GER) as a possible cause of recurrent bronchopulmonary infection in Chinese children, 23 patients were studied prospectively with 24-h pH monitoring. Their ages ranged from 3 to 25 months. The patients studied were chosen by the criterion of repeated, radiographically documented bronchopulmonary infection with a frequency of two or more episodes in the most recent 6 months, or a single episode with a protracted course longer than 3 months. Twenty-one of the 23 showed abnormal GER on 24-h pH monitoring. Twenty children received medical therapy, 17 of whom were followed regularly for 14-29 months. Eleven had subsidence or improvement of symptoms at follow-up. Follow-up pH monitoring was performed in 5 of the 11 patients, and showed improvement. Six failed to show improvement with medical therapy. Follow-up pH monitoring revealed increased reflux in two of them. Three of the six received fundoplication and had marked improvement of reflux and symptoms postoperatively. Clinical resolution corresponded well to 24-h pH monitoring. GER may be considered one of the possible contributing factors in any child with chronic recurrent bronchopulmonary infection, and antireflux therapy might be beneficial. Twenty-four hour pH monitoring was the best single test for diagnosing GER and determining the severity of the disease.