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Gastro-oesophageal reflux in infants under 6 months with cystic fibrosis
R G Heine1, B M Button, A Olinsky
1Department of Gastroenterology, Royal Children's Hospital, Melbourne, Australia.
Insights
Approximately 19% of infants with cystic fibrosis (CF) experience pathological gastro-oesophageal reflux (GOR). Frequent vomiting was the only identified predictor of increased reflux in these infants before lung disease develops.
Area of Science:
- Pediatric Gastroenterology
- Pulmonology
- Gastroenterology
Background:
- Cystic Fibrosis (CF) is a genetic disorder affecting multiple organs.
- Gastro-oesophageal reflux (GOR) is a common complication in infants.
- Early identification of GOR in CF infants is crucial for management.
Purpose of the Study:
- To determine the incidence of pathological GOR in infants diagnosed with CF.
- To identify clinical factors that predict increased GOR in this population.
Main Methods:
- 26 infants diagnosed with CF (age < 6 months) underwent prolonged esophageal pH monitoring.
- Correlation analysis was performed between pH monitoring data and clinical variables (symptoms, anthropometrics, genotype, etc.).
Main Results:
- 19.2% of infants had abnormal fractional reflux time (>10%).
- Frequent vomiting was significantly associated with higher fractional reflux time.
- No significant association was found between GOR and chest x-ray findings, sex, genotype, nutritional status, or meconium ileus.
Conclusions:
- Pathological GOR affects nearly one in five newly diagnosed infants with CF.
- GOR can be present before radiological evidence of lung disease.
- Frequent vomiting is a potential indicator of pathological GOR in infants with CF, but other clinical predictors are limited.
Aim:
To establish the incidence of pathological gastro-oesophageal reflux (GOR) in newly diagnosed infants with cystic fibrosis and to identify clinical predictors of increased reflux.
Methods:
26 infants with cystic fibrosis less than 6 months of age (14 male, 12 female; mean (SEM) age 2.1 (0.21) months, range 0.8 to 5.6 months) underwent prolonged oesophageal pH monitoring (mean duration 27.1 (0.49) hours; range 21.3 to 30.2 hours). Reflux symptoms, anthropometric variables, pancreatic status, meconium ileus, genotype, and chest x ray findings were correlated with pH monitoring data.
Results:
Five infants (19.2%) had an abnormal fractional reflux time of greater than 10%, seven (26.9%) of 5-10%, and 14 (53.8%) of below 5%. Infants who presented with frequent vomiting had a significantly higher fractional reflux time than infants who had infrequent or no vomiting. There was no significant association between abnormal chest x rays and pathological GOR. Sex, genotype, nutritional status, meconium ileus, and pancreatic enzyme supplementation were not significantly associated with pathological GOR.
Conclusions:
About one in five newly diagnosed infants with cystic fibrosis had pathological GOR. Pathologically increased reflux was present before radiological lung disease was established. Apart from frequent vomiting, no useful clinical predictors of pathological reflux were found.
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