Gastroesophageal reflux disease in children with recurrent and chronic respiratory diseases: Frequency and information content of various diagnostic methods

Gastroesophageal reflux disease (GERD) has bronchopulmonary manifestations, often associated with recurrent and chronic respiratory diseases (RaCRD). Objective of the research: To determine the frequency of GERD in children with RaCRD and to assess the information content of various diagnostic methods. Materials and methods: Using the GERD-Q questionnaire and considering GERD equivalent symptoms, results of esophageal fluoroscopy with contrasting, esophagogastroduodenoscopy (EGDS), daily pH-metry, daily intra-esophageal combined impedance-pH-metry (CIM), 125 children aged 1 month to 17 years with RaCRD were examined. Results: In children with RaCRD the frequency of gastroesophageal reflux detected with maximum frequency (93%) using CIM was 90,4%, while 49,6% of patients did not have esophageal clinical manifestations of GERD. Among children without esophageal manifestations of GERD, reflux was confirmed by instrumental methods in 80,7% of patients. The leading type of reflux in children with RaCRD is sub-acid reflux, which is more common in children without esophageal manifestations of GERD. The prognostic significance of a positive result of esophagus fluoroscopy, endoscopy, and pH-metry is quite high (93,8–100%), but the prognostic significance of a negative result is very low (14,3–20%). Conclusion: GERD screening is possible in children with RaCRD, regardless of the clinical manifestations of GERD; for the diagnosis of GERD in these children CIM is recommended. © 2019, Pediatria Ltd. All right reserved