Diagnosis and treatment of gastroesophageal reflux in 500 children with respiratory symptoms: the value of pH monitoring.

摘要: Abstract Gastroesophageal reflux (GER) usually presents with digestive symptoms, failure to thrive, and/or respiratory symptoms. During the 8-year period from 1981 1989, 1, 153 children underwent 20-hour pH monitoring assess GER. All patients were graded using scoring system of Euler and Byrne. Patients classified as severe (score greater than 50), moderate 25 normal less 25). Five hundred (43.3%) these presented symptoms including apnea, cyanosis, or “near miss” sudden infant death syndrome (36%), poorly controlled asthma (28%), recurrent bronchopneumonia (13%), bronchiolitis (9%), miscellaneous such intermittent dyspnea, chronic cough, stridor (12%). Eight (2%) had cystic fibrosis. The ages ranged 1 month 20 years (mean, 19.5 months). Twelve technically inadequate studies excluded. Severe was present in 156 (31%) 159 (31%). treated initially by medical therapy for a minimum 8 weeks. majority (81%) resolution their change position, thickened feedings, and, when indicated, additional metoclopramide, cisapride, domperidone. Most found have specific prone, which decreased reflux. remaining 57 documentation persistant an antireflux procedure. Of those undergoing surgery, 51 6 Fourty-four posterior 270° wrap (Toupet), 10 360° (Nissen), 3 anterior 180° (Boix-Ochoa). Thirty-eight (67%) 14 (25%) improvement after surgery. Early diagnosis GER may allow identification who will benefit treatment