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Gastroesophageal reflux in children with functional constipation
Maşallah Baran1, Funda Özgenç, Çiğdem Arikan
1Ege University Medical Faculty, Department of Pediatric Gastroenterology, Hepatology and Nutrition, İzmir, Turkey. baran19712002@yahoo.com
Insights
Gastroesophageal reflux disease (GERD) is common in children with functional constipation, with similar reflux rates observed in both groups. GERD should be considered in managing pediatric functional constipation.
Area of Science:
- Pediatric Gastroenterology
- Digestive System Disorders
- Functional Gastrointestinal Disorders
Background:
- Functional constipation and gastroesophageal reflux disease (GERD) are prevalent childhood functional gastrointestinal disorders.
- Adult studies show overlap between functional digestive tract disorders.
- This study investigates GERD frequency in children with functional constipation.
Purpose of the Study:
- To determine the frequency of GERD in children diagnosed with functional constipation.
- To compare clinical symptoms and 24-hour esophageal pH monitoring results between children with functional constipation and those with suspected GERD.
Main Methods:
- Prospective evaluation of 38 children (4-16 years) with functional constipation (Rome III criteria).
- A control group of 40 children with suspected GERD symptoms was included.
- All participants underwent symptom assessment and 24-hour esophageal pH monitoring.
Main Results:
- Belching and hiccups were more frequent in children with functional constipation.
- Chronic cough was more common in the suspected GERD group.
- Pathologic acid reflux was found in 39.5% of functional constipation patients and 42.5% of suspected GERD patients (no significant difference).
- Pyrosis was more common in functional constipation patients with acid reflux.
Conclusions:
- Gastroesophageal reflux disease (GERD) is a relevant consideration in the management of pediatric functional constipation.
- Further research using 24-hour pH multichannel impedance is recommended.
Background/Aims:
Functional constipation and gastroesophageal reflux disease are two major and commonly encountered components of childhood functional gastrointestinal disorders. Epidemiological studies in the adult population support that there is a significant overlap between the different functional disorders of the digestive tract. Therefore, we aimed to investigate the frequency of gastroesophageal reflux disease in children with functional constipation and to compare clinical findings and 24-h esophageal pH monitoring with a group of patients with suspected gastroesophageal reflux disease.
Materials And Methods:
Children between 4 and 16 years old with functional constipation (based on Rome III criteria, Group 1; n=38) were prospectively evaluated. A control group was composed of patients with symptoms suggesting gastroesophageal reflux disease (Group 2; n= 40). All patients included in the study were asked about reflux-related symptoms, and then all cases underwent 24-h esophageal pH monitoring analysis.
Results:
Delayed gastric emptying symptoms such as belching and hiccups were more common in patients in Group 1 (p=0.002, p=0.021, respectively), whereas chronic cough was more common in patients in Group 2 (p=0.012). According to the 24-h esophageal pH monitoring, pathologic acid reflux in the lower and/or laryngopharyngeal portion of the esophagus was determined in 39.5% of the patients in Group 1 and in 42.5% of the patients in Group 2 (p=0.96). No significant difference was found in terms of age, gender and duration of constipation in patients with and without acid reflux in Group 1 patients. Pyrosis (66.6 vs. 0%, p=0.00001)was more common in Group 1 patients with acid reflux, but hiccups (20 vs. 69.5%, p=0.007) and belching (33.3 vs. 60.8%, p=0.184) were more common in patients in Group 1 without acid reflux.
Conclusions:
Gastroesophageal reflux disease should be considered in the treatment and monitoring of patients with functional constipation. Further studies are needed using 24-h pH multichannel impedance.
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