Significance of Extra-Esophageal Symptoms in Pediatric Gastroesophageal Reflux Disease

Abstract

Introduction Current practice guidelines in gastroesophageal reflux disease (GERD) often require invasive diagnostic testing. Objective The aim of the present study was to evaluate the significance of extra-esophageal symptoms and reliability of a screening risk score that is simple to use. Methods A longitudinal retrospective single-institution cohort study. Setting: A university clinical hospital tertiary referral center. The present study enrolled pediatric patients with symptoms suggestive of GERD: epigastric pain, occasional nausea, regurgitation, tasting acid in the oral cavity, chronic cough, hoarseness of voice, frequent throat clearing. The patients underwent 24-hour esophageal pH monitoring and fiber-optic laryngoscopy. The correlations between the local findings, anamnestic and objective measurement data were analyzed. Results The present study evaluated 89 pediatric patients. Patients with asthma presented significantly more often with adjoining gastrointestinal symptoms (p = 0.0472). Patients that were obese were linked to a higher rate of reports of gastrointestinal symptoms (p = 0.0495). After the patients had been assigned to newly developed risk groups, obesity showed to be significantly more frequent in patients placed in higher risk groups (p < 0.0001) for a positive GERD diagnosis. Conclusion Patients with leading symptoms of asthma presented significantly more often with adjoining gastrointestinal symptoms. Obesity showed to be significantly more frequent in patients placed in higher risk groups for a positive GERD diagnosis.

Pediatric Laryngopharyngeal Reflux in the Last Decade: What Is New and Where to Next?

“…They proposed a pediatric LRP diagnostic probability scoring tool that took into account relevant symptoms and local findings in oropharyngoscopy and fiberoptic endoscopy, as well as the presence of obesity or associated comorbidities (such as asthma or recurrent laryngitis) [ 47 ]. In 2020, Košec et al created a new, elaborated form of this tool [ 28 ]. Both systems stratified patients into three grades, each with a different risk of LRP (low, moderate, or high risk for LPR).…”

Gastroesophageal reflux disease, obesity, bronchial asthma: simple combination or complex interaction

“…Ожирение -это патологическое состояние, провоцирующее гастроэофагеальный рефлюкс с клиническими проявлениями в виде рефлюкс-эзофагита (ГЭРБ) и рефлюкс-индуцированной бронхиальной астмы. Среди лиц, страдающих астмой, распространенность ГЭРБ и ожирения выше, чем среди населения в целом, то же самое верно и для распространенности астмы и ГЭРБ среди лиц с ожирением [76][77][78][79].…”

Pediatric Laryngopharyngeal Reflux: An Evidence-Based Review

“…According to controlled studies, infants or children with chronic otitis media with suppurations reported higher pepsin concentrations in middle ear secretions and acid pharyngeal reflux events at the dual-probe pH study than controls [ 50 , 54 ]. Other studies supported a potential association between reflux and chronic rhinosinusitis [ 56 , 57 , 58 ], choanal atresia [ 59 ], asthma and chronic aspirations [ 60 , 61 , 62 , 63 ], but the lack of controlled study with (HE)MII-pH limits the draw of reliable conclusions.…”

“…Surprisingly, few studies investigated the prevalence of symptoms and signs associated with P-LPR with validated clinical instruments. Clinical studies with the largest number of P-LPR cases are summarized in Table 2 [ 61 , 64 , 65 , 66 , 67 , 68 ]. The most prevalent symptoms associated with P-LPR include breathing disorders, chronic cough, hoarseness, and postnasal drip.…”

“…The most prevalent symptoms associated with P-LPR include breathing disorders, chronic cough, hoarseness, and postnasal drip. GERD-related symptoms include less prevalent overgrowth, especially in children [ 61 , 64 , 65 , 66 , 67 , 68 ]. The GERD symptoms are more prevalent in infants.…”