Gastroesophageal reflux disease: its importance in ear, nose, and throat practice.
OBJECTIVE
Gastroesophageal reflux disease (GERD) has been implicated in various extra-gastroesophageal diseases, especially in the upper and lower airways (atypical GERD). The objective of the present study was to determine the frequency of gastroesophageal and extra-gastroesophageal symptoms in pediatric patients with GERD and their response to the general treatment.


METHODS
A retrospective study was conducted on 45 children of both sexes aged 3 months-12 years with GERD diagnosed by clinical examination and 24h single-channel pHmetry. The gastroesophageal and extra-gastroesophageal symptoms, the treatment instituted and the response of the patients to the latter were determined.


RESULTS
Five symptomatologic groups were identified: gastroesophageal (51.11%), pulmonary (recurrent pneumonia, 40%, and bronchial asthma, 46.67%), chronic cough (64.44%), rhinologic (chronic nasal obstruction, 68.88%, nasal secretion, 55.55%, and nose itching, 46.66%), and pharyngo-otologic (recurrent acute middle ear infection, 35.56%, and recurrent tonsillitis, 24.44%). The response to treatment (antireflux drugs, antiallergic drugs, and surgical procedures) resulted in cure in 24 patients (53.34%), while 21 continued to be symptomatic. The cure rate was 69.56% for the gastroesophageal group, 100% for the recurrent pneumonia group, 80.95% for the bronchial asthma group, 68.96% for the chronic cough group, 83.87% for the chronic nasal obstruction group, 80% for the nasal secretion group, 85.71% for the nose itching group, 100% for the recurrent acute middle ear infection group, and 90.90% for the recurrent tonsillitis group. Total treatment time was 1.8 times longer for the remission of extra-gastroesophageal symptoms. Exclusive antireflux treatment promoted full remission of the otorhinolaryngologic symptoms in 38.89% of patients (nasal-41.17%, recurrent acute middle ear infection-12.5%, and recurrent tonsillitis-18.18%).


CONCLUSIONS
GERD can cause otorhinolaryngologic symptoms in children and remission of these symptoms can be obtained with antireflux therapy.
Megale
Silvia R M C L
SR
Service of Otorhinolaryngology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.
Scanavini
Adriana B A
AB
Andrade
Eduardo C
EC
Fernandes
Maria Inez Machado
MI
Anselmo-Lima
Wilma T
WT
D018926:Anti-Allergic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001249:Asthma / Q000209:etiology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003371:Cough / Q000209:etiology / Q000628:therapy; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D015508:Nasal Obstruction / Q000209:etiology / Q000628:therapy; D010033:Otitis Media / Q000209:etiology / Q000628:therapy; D013517:Otorhinolaryngologic Surgical Procedures; D011014:Pneumonia / Q000209:etiology / Q000628:therapy; D012008:Recurrence; D012189:Retrospective Studies; D014069:Tonsillitis / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome
D018926:Anti-Allergic Agents; D000897:Anti-Ulcer Agents