Nocturnal reflux in children and adolescents with persistent asthma and gastroesophageal reflux.
BACKGROUND
A higher frequency of nocturnal gastroesophageal reflux (GER) in adult patients with respiratory symptoms has been demonstrated. The aim of this study was to determine the prevalence of nocturnal GER by using prolonged intraesophageal pH monitoring and compare it with spirometry results in children with persistent asthma.


METHODS
Thirty-eight patients with persistent asthma for at least 2 years were studied. Gastrointestinal symptoms suggestive of GER were considered as regurgitation, heartburn, and abdominal pain. All patients underwent prolonged intraesophageal pH study and spirometry. GER was considered positive when a reflux index (RI) was higher than 5%. Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV(1)), forced mid-expiratory flow rate (FEF(25-75%)), and FEV(1)/FVC ratio were measured.


RESULTS
Median age was 10 years of age (range 5 to 15) and 58% were male; GER prevalence was 47.3%. Median (range) of reflux index during supine and upright periods from GER patients were, respectively, 8.7% (3.2 to 23.6) and 10.5% (5.2 to 15.0) (p = 0.913), and only FEF(25-75%) was below the predicted value: 54.5% (39.4 to 96.9). Reflux index was not significantly correlated with FVC, FEV(1) and FEF(25-75%).


CONCLUSIONS
A high prevalence of GER was found in children and adolescents with persistent asthma, equally distributed in the supine (nocturnal) and upright positions. There was no correlation with pulmonary function test.
Molle
Lucas Dalle
LD
Pediatric Gastroenterology Unit, Hospital de Clinicas de Porto Alegre-UFRGS, Porto Alegre, RS, Brazil. lucasdm@terra.com.br
Goldani
Helena A S
HA
Fagondes
Simone C
SC
Vieira
Vera G
VG
Barros
Sergio G S
SG
Silva
Paulo S
PS
Silveira
Themis R
TR
D000293:Adolescent; D017677:Age Distribution; D001249:Asthma / Q000175:diagnosis* / Q000453:epidemiology*; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002940:Circadian Rhythm; D015897:Comorbidity; D003430:Cross-Sectional Studies; D050782:Esophageal pH Monitoring; D005260:Female; D005541:Forced Expiratory Volume; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008365:Manometry; D015995:Prevalence; D011336:Probability; D011379:Prognosis; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D013147:Spirometry; D018709:Statistics, Nonparametric