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.
Service of Otorhinolaryngology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.
Silvia R M C L
SR
Megale
Adriana B A
AB
Scanavini
Eduardo C
EC
Andrade
Maria Inez Machado
MI
Fernandes
Wilma T
WT
Anselmo-Lima
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