Abstract
Although already reported before, the association between gastroesophageal reflux (GER) and respiratory disease (RD) has not been generally recognized before the late 70ies, related to the development of esophageal pH monitoring (Euler; Pediatrics 1979). Silent GER has been reported to occur in as much as 61% of children with RD (Buts; Eur J Pediatr 1986). We performed a pH monit in 83 children (age 2months-15 years) with RD without digestive manifestations. pH Data were abnormal (Vandenplas; J Pediatr Gastroenterol Nutr 1987) in 38/83 infants (46%). If GER was treated efficiently, pH data normalized and RD recovered (Malfroot;Pediatr Pulm 1987). A not sufficiently emphasized difficulty is that GER parameters have been defined by gastroenterologists interested in patients with emesis, esophagitis, failure to thrive (Johnson; Am J Gastro enterol 1974). Reviewing our pH data we were striked by a typical pH pattern in 25/83 infants (30%) with RD. Although all parameter were strictly within normal ranges in all infants, pH at night (4.2, range 4.0-4.8) was 1.0-2.3 pH (p<0.01) below mean pH (5.7, range 5.2-6.6) during day. Standard deviation of pH during night was smaller (0.67) versus daytime (1.43) (p<0.01). Similar tradings were not observed in asymptomatic infants, or infants with digestive manifestations. 9/25 infants in whom scintiscanning was abnormal were treated for GER, and 6 recovered from their RD, suggesting GER was responsable for their RD although pH monit was considered as normal. We conclude that criteria for abnormal pH monit in infants with RD might differ from those used in digestive manifestations.
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Vandenplas, Y., Malfroot, A. & Dab, I. 73 ESOPHAGEAL pH MONITORING CRITERIA IN INFANTS WITH RECURRENT RESPIRATORY DISEASE. Pediatr Res 24, 417 (1988). https://doi.org/10.1203/00006450-198809000-00096
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DOI: https://doi.org/10.1203/00006450-198809000-00096