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Persistent wheezing and gastroesophageal reflux in infants
N S Eid1, R W Shepherd, M A Thomson
1Kosair Children's Hospital, Department of Pediatrics, School of Medicine, University of Louisville, Kentucky.
Pediatric Pulmonology
|July 1, 1994
Summary
Gastroesophageal reflux (GER) is a key factor in persistent infant wheezing. Treating GER, medically or surgically, can significantly improve or resolve wheezing symptoms in infants.
Area of Science:
- Pediatric Pulmonology
- Gastroenterology
Background:
- Persistent wheezing in infants often presents a diagnostic challenge.
- Standard asthma treatments may be ineffective in some cases.
Purpose of the Study:
- To evaluate the role of gastroesophageal reflux (GER) in infants with persistent wheezing.
- To assess the efficacy of GER treatment in resolving wheezing symptoms.
Main Methods:
- Study included 12 infants with persistent wheezing unresponsive to conventional therapy.
- Diagnostic methods included cineradiography and 24-hour pH monitoring for GER.
- Treatment involved medical management (prokinetics, H2 antagonists) and surgical intervention (fundoplication) for refractory cases.
Main Results:
- All 12 infants demonstrated GER; 6 achieved complete resolution of wheezing with medical therapy.
- Two patients showed significant improvement requiring intermittent therapy.
- Four patients underwent fundoplication with excellent outcomes, with only one needing further medication.
Conclusions:
- GER should be considered in the evaluation of infants with persistent wheezing.
- Aggressive medical and/or surgical treatment of GER can effectively resolve persistent wheezing in infants.