title: Time to stop blaming gastroesophageal reflux.
abstract: OBJECTIVES. Cough, pain, and desaturation episodes in infants are often ascribed to gastroesophageal reflux, and many are empirically treated with acid suppression medications. The authors hypothesize that most of these symptoms are not related to gastroesophageal reflux. METHODS. Retrospective review of 186 combined pH-multichannel intraluminal impedance studies performed in infants at Cincinnati Children's Hospital. RESULTS. Of 4159 symptoms reported 1504 (36%) were associated with reflux events (27% nonacid and 9% acid). When total number of symptoms and reflux events were taken into consideration, nonacid reflux events were as likely to be associated with a symptom as acid reflux events (P = .66). CONCLUSION. The extra-esophageal symptoms commonly attributed to gastroesophageal reflux in infants are most often not associated with a reflux event. Even though causality cannot be definitively proven, in the minority in whom a symptom association is observed, nonacid events are as likely as acid events to cause symptoms.
authors.affiliation: Cincinnati Children's Hospital Medical Center, OH, USA. jose.garza@cchmc.org
authors.forename: Jose M
authors.initials: JM
authors.lastname: Garza
authors.forename: Cade M
authors.initials: CM
authors.lastname: Nylund
authors.forename: Ajay
authors.initials: A
authors.lastname: Kaul
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000627:therapeutic use; D003371:Cough / Q000209:etiology*; D003937:Diagnosis, Differential; D017097:Electric Impedance; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D050782:Esophageal pH Monitoring; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D064747:Lansoprazole; D057045:Laryngopharyngeal Reflux / Q000209:etiology; D016015:Logistic Models; D008297:Male; D010146:Pain / Q000209:etiology*; D011899:Ranitidine / Q000627:therapeutic use; D012189:Retrospective Studies
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D004791:Enzyme Inhibitors; D006635:Histamine H2 Antagonists; D064747:Lansoprazole; D011899:Ranitidine