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Updated: Dec 4, 2025
Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
Published on: December 14, 2020
Significance of Extra-Esophageal Symptoms in Pediatric Gastroesophageal Reflux Disease
Andro Košec1, Orjena Žaja2, Filip Matovinović1
1Department of Otorhinolarygology and Head and Neck Surgery, University Clinical Hospital Centre Sestre Milosrdnice, Zagreb University School of Medicine, Zagreb, Croatia.
Insights
Gastroesophageal reflux disease (GERD) in children can be identified using a simple risk score. Obesity and asthma symptoms are linked to higher GERD risk, potentially reducing the need for invasive testing.
Area of Science:
- Pediatric Gastroenterology
- Otolaryngology
Background:
- Current gastroesophageal reflux disease (GERD) guidelines often necessitate invasive diagnostic procedures.
- Extra-esophageal symptoms are frequently associated with GERD in pediatric populations.
- There is a need for simpler, reliable screening tools for GERD diagnosis.
Purpose of the Study:
- To assess the significance of extra-esophageal symptoms in pediatric GERD.
- To evaluate the reliability of a novel, user-friendly screening risk score for GERD.
- To explore correlations between symptoms, patient characteristics, and objective diagnostic findings.
Main Methods:
- A retrospective, single-institution cohort study involving 89 pediatric patients with suspected GERD.
- Data collection included patient history (epigastric pain, nausea, regurgitation, cough, hoarseness), 24-hour esophageal pH monitoring, and fiber-optic laryngoscopy.
- Patients were categorized into newly developed risk groups based on a screening score.
Main Results:
- Pediatric patients with asthma showed a statistically significant higher incidence of concurrent gastrointestinal symptoms (p=0.0472).
- Obesity was significantly associated with an increased reporting of gastrointestinal symptoms (p=0.0495).
- Obesity was found to be significantly more prevalent in higher risk groups for positive GERD diagnosis (p<0.0001).
Conclusions:
- Asthma as a primary symptom in children is frequently accompanied by gastrointestinal manifestations suggestive of GERD.
- Obesity is a significant indicator for higher risk groups in pediatric GERD diagnosis.
- The developed risk score shows promise in identifying children at higher risk for GERD, potentially guiding further diagnostic steps.
Abstract:
Introduction Current practice guidelines in gastroesophageal reflux disease (GERD) often require invasive diagnostic testing. Objective The aim of the present study was to evaluate the significance of extra-esophageal symptoms and reliability of a screening risk score that is simple to use. Methods A longitudinal retrospective single-institution cohort study. Setting: A university clinical hospital tertiary referral center. The present study enrolled pediatric patients with symptoms suggestive of GERD: epigastric pain, occasional nausea, regurgitation, tasting acid in the oral cavity, chronic cough, hoarseness of voice, frequent throat clearing. The patients underwent 24-hour esophageal pH monitoring and fiber-optic laryngoscopy. The correlations between the local findings, anamnestic and objective measurement data were analyzed. Results The present study evaluated 89 pediatric patients. Patients with asthma presented significantly more often with adjoining gastrointestinal symptoms ( p = 0.0472). Patients that were obese were linked to a higher rate of reports of gastrointestinal symptoms ( p = 0.0495). After the patients had been assigned to newly developed risk groups, obesity showed to be significantly more frequent in patients placed in higher risk groups ( p < 0.0001) for a positive GERD diagnosis. Conclusion Patients with leading symptoms of asthma presented significantly more often with adjoining gastrointestinal symptoms. Obesity showed to be significantly more frequent in patients placed in higher risk groups for a positive GERD diagnosis.
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