Gastroesophageal reflux disease in children and adolescents in primary care.
OBJECTIVE
To determine the prevalence and incidence of a diagnosis of gastroesophageal reflux disease (GERD) in children and adolescents in UK primary care, and to assess comorbidities that are associated with a diagnosis of GERD.


METHODS
Incident GERD cases during 2000-05 were identified from The Health Improvement Network (THIN) UK primary care database via a computer search for diagnostic codes for GERD, followed by manual review of the patient records.


RESULTS
We identified 1700 children with a first diagnosis of GERD during 2000-05. The incidence of GERD was 0.84 per 1000 person-years. The incidence decreased with age from 1.48 per 1000 person-years among 1-year-old children until the age of 12 years, whereupon it increased to a maximum at 16-17 years of 2.26 per 1000 person-years for girls and 1.75 per 1000 person-years for boys. Pregnant adolescents were not included in the study. In addition to typical GERD symptoms (epigastric pain, heartburn, reflux, regurgitation), 21.2% of children reported nausea or vomiting. Children with neurological disorders were at increased risk of a GERD diagnosis. Hiatus hernia and congenital esophageal disorders were also associated with a diagnosis of GERD. Children and adolescents using antiepileptics, oral/inhaled steroids, beta-agonists and paracetamol had an increased risk of a GERD diagnosis.


CONCLUSIONS
The incidence of a GERD diagnosis was age-dependent and was highest among very young children and older female adolescents. Children with neurological impairments and other comorbidities were at increased risk of a GERD diagnosis.
Ruigómez
Ana
A
Spanish Centre for Pharmacoepidemiological Research (CEIFE), Madrid, Spain. aruigomez@ceife.es
Wallander
Mari-Ann
MA
Lundborg
Per
P
Johansson
Saga
S
Rodriguez
Luis A Garcia
LA
D000082:Acetaminophen / Q000009:adverse effects; D000293:Adolescent; D000318:Adrenergic beta-Agonists / Q000009:adverse effects; D000927:Anticonvulsants / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004935:Esophageal Diseases / Q000150:complications / Q000151:congenital; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D006551:Hernia, Hiatal / Q000150:complications / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012307:Risk Factors; D013256:Steroids / Q000009:adverse effects; D006113:United Kingdom
D000318:Adrenergic beta-Agonists; D000927:Anticonvulsants; D013256:Steroids; D000082:Acetaminophen