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Recurrent pulmonary disease in children: a complication of gastroesophageal reflux
Insights
Gastroesophageal reflux (GER) is a potential cause of recurrent lung disease in children. Esophageal function tests can help identify GER in pediatric patients with chronic asthma or recurrent pneumonia.
Area of Science:
- Pediatric Pulmonology
- Gastroenterology
- Diagnostic Medicine
Background:
- Recurrent pulmonary disease in children poses a diagnostic challenge.
- Gastroesophageal reflux (GER) is increasingly recognized as an extraesophageal manifestation.
Purpose of the Study:
- To investigate the prevalence of GER in children with recurrent pulmonary disease.
- To assess the utility of esophageal function tests in diagnosing GER in this population.
Main Methods:
- Prospective study of 30 children (aged 1-18 years) with chronic asthma or recurrent pneumonia.
- Utilized esophagram, esophageal manometry, pH probe (Tuttle) test, and esophagoscopy with biopsy.
Main Results:
- Nineteen out of 30 children (63%) showed evidence of GER based on multiple positive tests.
- Positive findings included abnormal Tuttle tests (18), manometry (13), esophagitis on biopsy (9), and esophagoscopy (6).
- Nocturnal cough (17) and infantile vomiting (8) were noted in children with GER.
Conclusions:
- GER is a significant factor in pediatric recurrent pulmonary disease.
- Esophageal function testing is recommended for children with recurrent pulmonary disease to rule out GER.
Abstract:
To evaluate the role of gastroesophageal reflux (GER) as a possible cause of recurrent pulmonary disease, 30 children, aged 1 to 18 years, were studied prospectively with esophageal function tests. These included esophagram (30 patients), esophageal manometry (29 patients), pH probe (Tuttle) test (29 patients), and esophagoscopy with esophageal biopsy (23 patients). The patients studied had either chronic asthma or two or more documented pneumonias within a one-year period. Nineteen (63%) had GER based on two or more positive tests. Eighteen had positive Tuttle tests; 13 had abnormal manometry studies; nine had esophagitis on biopsy; six had esophagitis on esophagoscopy; and five had reflux on esophagram. Of those with GER, 17 had a history of nocturnal cough and eight vomited during infancy. Children with recurrent pulmonary disease should have esophageal function testing to exclude GER as the cause.