Circadian variation of gastroesophageal reflux in children.
Asymptomatic infants and infants with gastroesophageal reflux have been noted to have peak reflux in the midafternoon. The aim of this study was to examine circadian variation of gastroesophageal reflux in children with both normal and abnormal 24-hr esophageal pH probe studies. Eighty-seven patients were studied and 15 of these patients were found to have a reflux index >4% for the duration of the study. These 15 patients were found to have significant circadian variation. Peak reflux indices (mean 12.60%) were detected in the mid-afternoon, with a smaller peak at night (mean 8.07%). Trough indices (mean 2.60%) occurred in the early morning. The 72 patients with normal studies were found to have less circadian variation, although peak reflux indices (mean 1.76%) occurred in the early morning. Clinicians should target their antireflux therapy to periods of peak gastroesophageal reflux.
Steiner
Steven J
SJ
Department of Pediatrics, James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana 46202-5225, USA.
Croffie
Joseph M
JM
Gupta
Sandeep K
SK
Pfefferkorn
Marian D
MD
Fitzgerald
Joseph F
JF
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002940:Circadian Rhythm; D005260:Female; D005764:Gastroesophageal Reflux / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies