Association of reflux with otitis media in children.
OBJECTIVE
To confirm the finding of pepsin/pepsinogen in middle ear fluid of children with chronic or recurrent otitis media (OME or ROM), and to ask parents about symptoms associated with gastroesophageal reflux (GER).


METHODS
Middle ear fluid was collected from children undergoing tympanostomy tube placement. We tested this fluid for pepsin/pepsinogen using a proteolytic enzyme assay and an ELISA. Parents completed questionnaires about symptoms of GER in their children.


RESULTS
We collected 36 samples from 22 children; 16 of 22 children (73%) were positive with the proteolytic assay; 17 (77%) were positive with ELISA. Questionnaires did not show increased GER symptoms.


CONCLUSIONS
We replicated the finding of pepsin/pepsinogen in middle ear fluid of children with OME or ROM, but did not find any increase in GER symptoms. Further research is needed to establish a causative link between GER and OM.
Lieu
Judith E C
JE
Department of Otolaryngology--Head and Neck Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA. lieuj@ent.wustl.edu
Muthappan
P Ganesh
PG
Uppaluri
Ravindra
R
D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004432:Ear, Middle; D004797:Enzyme-Linked Immunosorbent Assay; D005122:Exudates and Transudates / Q000737:chemistry; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D008297:Male; D008876:Middle Ear Ventilation; D010034:Otitis Media with Effusion / Q000453:epidemiology* / Q000601:surgery; D010434:Pepsin A / Q000032:analysis; D020116:Pepsinogen A / Q000032:analysis; D010447:Peptide Hydrolases; D011446:Prospective Studies; D012008:Recurrence; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods; D011795:Surveys and Questionnaires
D020116:Pepsinogen A; D010447:Peptide Hydrolases; D010434:Pepsin A