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[Recurrent obstructive bronchitis in infants]
Insights
Gastroesophageal reflux is common in infants with recurrent obstructive bronchitis, often without vomiting. Treating reflux improves respiratory symptoms and sphincter function, but failure may lead to asthma.
Area of Science:
- Pediatrics
- Gastroenterology
- Pulmonology
Context:
- Recurrent obstructive bronchitis in infants is a common clinical problem.
- Gastroesophageal reflux (GER) is a potential contributing factor.
- Diagnostic methods include clinical evaluation, chest X-rays, and manometry.
Purpose:
- To investigate the prevalence of gastroesophageal reflux in infants with recurrent obstructive bronchitis.
- To assess the relationship between GER and gastroesophageal sphincter function.
- To evaluate the efficacy of medical treatment for GER on respiratory symptoms and sphincter function.
Summary:
- The study included 458 infants with recurrent obstructive bronchitis.
- Radiological reflux was detected in 49.1% of infants, with shorter and lower-pressure gastroesophageal sphincters compared to controls.
- Medical treatment of GER resulted in symptom remission in 63.5% and improved sphincter function.
- Long-term follow-up revealed asthma development in 56.6% of those unresponsive to treatment.
Impact:
- Highlights the significant role of GER in infant respiratory distress.
- Demonstrates the therapeutic benefit of GER management in pediatric obstructive bronchitis.
- Identifies potential risk factors for developing bronchial asthma in infants with persistent GER.
Abstract:
The study comprised 458 infants complaining of recurrent obstructive bronchitis from the clinical, chest X-rays and gastroesophageal reflux investigation view points. Spontaneous radiological reflux was found in 49.1% of the patients, although a history of vomiting was present only in 26.6%. In infants with positive radiological reflux, manometrics showed a shorter gastroesophageal sphincter and with lesser pressures than a group of normal infants. With medical treatment of the reflux, remission of the respiratory symptoms was seen in 63.5% of the patients. In a group of infants treated, control X-rays, and manometrics were practiced at the end of the medical treatment showing significant improvement of pressure and length of the gastroesophageal sphincter. The long-term follow-up in infants showing failure of the medical treatment, bronchial asthma appeared in 56.6%.