Objectives: Respiratory symptoms are a possible atypical clinical picture of gastro-esophageal reflux disease (GERD). However, a significant number of patients with GERD-related respiratory symptoms do not report improvement despite aggressive acid-suppressive therapy. Some of these refractory casesmay be due to the recently appreciated entity of non-acid or weakly acidic reflux. The aim of our study is to assess the pH-impedance features of GER inducing airway symptoms, compared with GER inducing typical gastro-intestinal (GI) symptoms. Methods: We prospectively enrolled infants and children with GERD-related respiratory symptoms from January 2015 to December 2015. Age-and sex-matched patients with GERD-related GI symptoms were enrolled as comparison group. The overall number, the acidity pattern, and the height of reflux episodes were compared between the two groups. Results: Forty patients (M/F: 20/20; mean age: 58.3 months) were enrolled in the study group and 40 in the comparison group. The mean acid exposure index was 7.9% within the study group and 15.9% within the comparison group (p:0.026). Children with respiratory symptoms versus children with GI symptoms had a mean of 40.8 acid reflux episodes versus 62.4 (p:0.001), a mean of 2.2 weakly acid reflux episodes versus 20.1 (p:0.002), and a mean of 22.1 weakly alkaline reflux episodes versus 10.2 (P < 0.001). Separate analysis of both infants and children was performed. Conclusions: The main finding of this prospective, controlled study is that children >1 year with GERD-related respiratory symptoms showed a significantly higher number of weakly alkaline refluxes than children with GERD-related GI symptoms. This supports the hypothesis that respiratory symptoms are less related to acidity than GI symptoms.

Role of non-acid gastro-esophageal reflux in children with respiratory symptoms / Zenzeri, L; Quitadamo, P; Tambucci, R; Ummarino, D; Poziello, A; Miele, E; Staiano, A.. - In: PEDIATRIC PULMONOLOGY. - ISSN 1099-0496. - 52:5(2017), pp. 669-674. [10.1002/ppul.23619]

Role of non-acid gastro-esophageal reflux in children with respiratory symptoms

Zenzeri L;
2017

Abstract

Objectives: Respiratory symptoms are a possible atypical clinical picture of gastro-esophageal reflux disease (GERD). However, a significant number of patients with GERD-related respiratory symptoms do not report improvement despite aggressive acid-suppressive therapy. Some of these refractory casesmay be due to the recently appreciated entity of non-acid or weakly acidic reflux. The aim of our study is to assess the pH-impedance features of GER inducing airway symptoms, compared with GER inducing typical gastro-intestinal (GI) symptoms. Methods: We prospectively enrolled infants and children with GERD-related respiratory symptoms from January 2015 to December 2015. Age-and sex-matched patients with GERD-related GI symptoms were enrolled as comparison group. The overall number, the acidity pattern, and the height of reflux episodes were compared between the two groups. Results: Forty patients (M/F: 20/20; mean age: 58.3 months) were enrolled in the study group and 40 in the comparison group. The mean acid exposure index was 7.9% within the study group and 15.9% within the comparison group (p:0.026). Children with respiratory symptoms versus children with GI symptoms had a mean of 40.8 acid reflux episodes versus 62.4 (p:0.001), a mean of 2.2 weakly acid reflux episodes versus 20.1 (p:0.002), and a mean of 22.1 weakly alkaline reflux episodes versus 10.2 (P < 0.001). Separate analysis of both infants and children was performed. Conclusions: The main finding of this prospective, controlled study is that children >1 year with GERD-related respiratory symptoms showed a significantly higher number of weakly alkaline refluxes than children with GERD-related GI symptoms. This supports the hypothesis that respiratory symptoms are less related to acidity than GI symptoms.
2017
reflux; pH-impedance monitoring; respiratory symptoms; children
01 Pubblicazione su rivista::01a Articolo in rivista
Role of non-acid gastro-esophageal reflux in children with respiratory symptoms / Zenzeri, L; Quitadamo, P; Tambucci, R; Ummarino, D; Poziello, A; Miele, E; Staiano, A.. - In: PEDIATRIC PULMONOLOGY. - ISSN 1099-0496. - 52:5(2017), pp. 669-674. [10.1002/ppul.23619]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1560687
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