Gastro-oesophageal reflux in infants under 6 months with cystic fibrosis.
OBJECTIVE
To establish the incidence of pathological gastro-oesophageal reflux (GOR) in newly diagnosed infants with cystic fibrosis and to identify clinical predictors of increased reflux.


METHODS
26 infants with cystic fibrosis less than 6 months of age (14 male, 12 female; mean (SEM) age 2.1 (0.21) months, range 0.8 to 5.6 months) underwent prolonged oesophageal pH monitoring (mean duration 27.1 (0.49) hours; range 21.3 to 30.2 hours). Reflux symptoms, anthropometric variables, pancreatic status, meconium ileus, genotype, and chest x ray findings were correlated with pH monitoring data.


RESULTS
Five infants (19.2%) had an abnormal fractional reflux time of greater than 10%, seven (26.9%) of 5-10%, and 14 (53.8%) of below 5%. Infants who presented with frequent vomiting had a significantly higher fractional reflux time than infants who had infrequent or no vomiting. There was no significant association between abnormal chest x rays and pathological GOR. Sex, genotype, nutritional status, meconium ileus, and pancreatic enzyme supplementation were not significantly associated with pathological GOR.


CONCLUSIONS
About one in five newly diagnosed infants with cystic fibrosis had pathological GOR. Pathologically increased reflux was present before radiological lung disease was established. Apart from frequent vomiting, no useful clinical predictors of pathological reflux were found.
Heine
R G
RG
Department of Gastroenterology, Royal Children's Hospital, Melbourne, Australia.
Button
B M
BM
Olinsky
A
A
Phelan
P D
PD
Catto-Smith
A G
AG
D003550:Cystic Fibrosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D004947:Esophagus / Q000378:metabolism; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007415:Intestinal Obstruction / Q000209:etiology; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D015596:Nutrition Assessment; D010179:Pancreas / Q000503:physiopathology; D011859:Radiography; D014839:Vomiting / Q000209:etiology