[Long-term observation of children with gastro-esophageal reflux disease].
BACKGROUND
Gastroesophageal reflux disease (GERD) is frequent disorder of the gastro-intestinal tract. Although in adults GERD is regarded as a chronic disease, in children it is often considered as a transient disorder.


OBJECTIVE
To assess the natural history of GERD in infants and children.


METHODS
We enrolled 163 children (44% girls and 56% boys) with GERD diagnosed on the basis of esophageal symptoms and positive result of 24-hour pH-monitoring (fraction time - fT > 4.2%). The mean age at the time of the diagnosis was 4.5 year. After 3.5 years from the diagnosis, the patients or guardians filled in a custom-made questionnaire evaluating GERD symptoms: heartburn, belching, vomiting, regurgitations, feeding problems, dysphagia, epigastric pain. Control pH-monitoring was performed in 71 of the patients. The patients were divided into three age groups: group I--below 1 year of age (38 children), group II--between 1 and 4 years of age (35 children) and group III--above 4 years of age (90 children).


RESULTS
GERD symptoms disappeared completely in 45%, 14.3% and 13.4% from group I, II and III, respectively. In 38 (54%) patients the control pH-monitoring revealed pathologic acid reflux, including 4 children without any GERD symptoms.


CONCLUSIONS
The study shows that in children aged above 1 year GERD symptoms are unlikely to subside completely. Moreover, acid gastroesophageal reflux may still be present, despite the absence of the clinical symptoms.
Jastrzebska
Izabela
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Klinika Pediatrii, Gastroenterologii i Zywienia, Uniwersytet Jagielloński Collegium Medicum w Krakowie. dobosz@mp.pl
Fyderek
Krzysztof
K
D002675:Child, Preschool; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000503:physiopathology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007223:Infant; D008297:Male; D018670:Monitoring, Ambulatory; D013997:Time Factors