Related Experiment Video

Updated: May 8, 2026

Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
06:46

Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring

Published on: December 14, 2020

Prevalence of pediatric aspiration-associated extraesophageal reflux disease

Elizabeth A Kelly, Daiva E Parakininkas, Steven L Werlin

    JAMA Otolaryngology-- Head & Neck Surgery
    |August 31, 2013
    PubMed

    Insights

    Aspiration-associated extraesophageal reflux disease (AERD) is common in children with chronic lung issues. Pepsin in bronchoalveolar lavage fluid is a promising biomarker for AERD, outperforming lipid-laden macrophages.

    Area of Science:

    • Pulmonology
    • Gastroenterology
    • Pediatric Medicine

    Background:

    • The role of aspiration-associated extraesophageal reflux disease (AERD) in pediatric chronic respiratory symptoms remains unclear.
    • Identifying AERD prevalence is crucial for guiding treatment strategies in affected children.

    Purpose of the Study:

    • To determine the prevalence of AERD in pediatric patients presenting with chronic respiratory symptoms.
    • To evaluate the diagnostic utility of pepsin as a novel biomarker for AERD.

    Main Methods:

    • A case-control study was conducted between 2008 and 2012 at a tertiary referral center.
    • Bronchoalveolar lavage fluid specimens were analyzed using Western blot for pepsin and oil red O staining for lipid-laden macrophages (LLMs).
    • 34 pediatric patients with chronic pulmonary disease and 11 controls were included.

    Main Results:

    • Pepsin was detected in 74% of patients who underwent bronchoscopy and 71% of patients with tracheostomy.
    • Lipid-laden macrophages (LLMs) were present in 91% of the bronchoscopy group and 52% of the tracheostomy group.
    • Pepsin was absent in all control specimens, while LLMs were found in 64% of controls.

    Conclusions:

    • Pediatric patients with chronic pulmonary disease exhibit a high prevalence of AERD, suggesting significant treatment implications.
    • Pepsin detection in bronchoalveolar lavage fluid is a more effective predictor of AERD than LLMs in this population.
    • Pepsin serves as a valuable biomarker for AERD, potentially offering a superior diagnostic approach compared to LLM analysis.
    Abstract

    More Related Videos

    Conditional Reprogramming of Pediatric Human Esophageal Epithelial Cells for Use in Tissue Engineering and Disease Investigation10:15

    Conditional Reprogramming of Pediatric Human Esophageal Epithelial Cells for Use in Tissue Engineering and Disease Investigation

    Published on: March 22, 2017

    Surgical Models of Gastroesophageal Reflux with Mice05:19

    Surgical Models of Gastroesophageal Reflux with Mice

    Published on: August 25, 2015

    Related Concept Videos

    Gastroesophageal Reflux Disease01:25

    Gastroesophageal Reflux Disease

    Gastroesophageal reflux disease (GERD) is the backward flow of stomach contents (acid, pepsin, or bile) into the esophagus, causing mucosal inflammation known as esophagitis. It results from failure of antireflux mechanisms, mainly the lower esophageal sphincter (LES), influenced by mechanical and physiological factors.Etiology and Risk FactorsGERD develops when LES function is weakened or when intra-abdominal pressure increases. Risk factors include aging, obesity, and sliding hiatal hernia,...
    Gastroesophageal Reflux Disease II: Clinical Features and Management01:29

    Gastroesophageal Reflux Disease II: Clinical Features and Management

    Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
    Clinical Manifestations
    GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
    Gastroesophageal Reflux Disease I: Meaning and Pathophysiology01:29

    Gastroesophageal Reflux Disease I: Meaning and Pathophysiology

    Gastroesophageal Reflux Disease (GERD) involves the recurrent backflow of the stomach or duodenal contents into the esophagus, leading to troublesome symptoms and potential esophageal mucosal damage. Although GERD is often referred to as a disease, it is more accurately described as a syndrome, as it encompasses a range of symptoms and complications rather than a singular pathological entity, impacting a large number of individuals as the most prevalent upper gastrointestinal problem. Roughly...
    Esophageal Achalasia01:27

    Esophageal Achalasia

    Esophageal achalasia is a chronic neurogenic disorder characterized by impaired relaxation of the lower esophageal sphincter (LES) and absent or ineffective peristalsis in the distal esophagus. This leads to a functional obstruction without a physical blockage, despite significant disruption of esophageal motility.EtiologyAchalasia is caused by degeneration of the myenteric (Auerbach's) plexus, specifically the loss of inhibitory ganglion cells that produce vasoactive intestinal peptide (VIP)...
    Barrett Esophagus-I: Introduction01:21

    Barrett Esophagus-I: Introduction

    Barrett's esophagus is a medical condition where the esophageal mucosa is significantly damaged by stomach acid or other digestive fluids, often due to long-term exposure associated with gastroesophageal reflux disease (GERD). In GERD, a weakened or abnormally relaxed lower esophageal sphincter allows stomach acid to flow persistently into the esophagus.
    This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more similar...
    Barrett Esophagus-II: Clinical Manifestations and Management01:21

    Barrett Esophagus-II: Clinical Manifestations and Management

    Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
    To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure entails...