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[Gastroesophageal reflux with respiratory manifestations. Manometric and pH-metric study]
Insights
Gastroesophageal reflux is linked to respiratory issues in children, even without vomiting. Esophageal pH monitoring reveals significant reflux in these patients, suggesting a need for broader antireflux therapy.
Area of Science:
- Pediatric Gastroenterology
- Pulmonology
Context:
- Gastroesophageal reflux (GER) is increasingly recognized in pediatric respiratory diseases.
- Traditional diagnostic markers like vomiting may not always be present.
- Understanding the link between GER and respiratory symptoms is crucial for effective management.
Purpose:
- To investigate the relationship between gastroesophageal reflux and respiratory tract disease in children.
- To compare manometric and pH-metric findings in children with and without respiratory symptoms due to reflux.
- To assess the diagnostic utility of esophageal manometry and pH-metry in this population.
Summary:
- A study of 69 children with radiologic reflux (49 with respiratory symptoms) and 10 controls used manometry and pH-metry.
- Lower esophageal sphincter pressure was lower in refluxing patients, but significant only in those with vomiting.
- Prolonged esophageal pH-metry showed significantly abnormal reflux parameters in respiratory patients, similar to vomiting refluxers.
- Notably, 25-33% of these respiratory patients had normal manometric and pH-metric results.
Impact:
- Confirms a significant association between gastroesophageal reflux and bronchopulmonary disease in children.
- Suggests that antireflux therapy may benefit a wider range of pediatric respiratory conditions.
- Highlights the need for further research to refine indications for antireflux interventions in children with respiratory symptoms.
Abstract:
Gastroesophageal reflux can be found in patients with respiratory tract disease even in the absence of vomiting. A manometric and pH-metric study carried out in 69 children with radiologic reflux (of whom 49 had respiratory symptoms) and 10 normal controls has shown: 1. lower esophageal sphincter pressure was lower in refluxing patients than in controls, but values were significant only for those with vomiting; 2. all parameters of prolonged esophageal pH-metry indicating reflux were very significantly abnormal in the group of respiratory patients who were by this respect very similar to vomiting refluxers; 3. nevertheless, one fourth to one third of these patients were manometrically and pH-metrically normal. These data confirm that there is a relationship between gastroesophageal reflux and bronchopulmonary disease. A widening of the field of antireflux therapy can be predicted for the near future, although a further definition of the indications is necessary.