title: Lung diffusion capacity in children with respiratory symptoms and untreated GERD.
abstract: BACKGROUND
  Gastroesophageal reflux disease (GERD) is associated with many respiratory disorders, among which, chronic cough, laryngitis, and asthma are among the most common. We investigated lung function, including gas diffusion capacity, in children with poor asthma control or chronic laryngitis with untreated GERD.
  
  
  METHODS
  A total of 71 children, aged 6-17 years, with chronic respiratory and other symptoms suggestive for GERD, were enrolled and divided into 2 groups: chronic laryngitis and asthma. Participants underwent 24-hour pH monitoring and lung function assessment, measurement of single-breath diffusing capacity of the lung for carbon monoxide (DLCO), and fraction of exhaled nitric oxide (FENO) measurement.
  
  
  RESULTS
  24-hour pH monitoring was positive for GERD in 92.1% of preselected children with asthma and 90.1% of children with chronic recurrent laryngitis. All flows (PEF, MEF75, MEF50, and MEF25) were significantly lower in the asthma group, while FENO and DLCO were significantly lower in the laryngitis group. A significant inverse relationship was found between DLCO and all reflux indexes in the laryngitis group. Each unit change of Johnson-DeMeester score and Boix-Ochoa score increased the odds for significantly lower DLCO in laryngitis patients by 3.9% and 5.5%, respectively.
  
  
  CONCLUSIONS
  In children with uncontrolled asthma and chronic laryngitis, the regurgitation of gastric contents due to GERD contributes to poor asthma control and aggravation of chronic laryngitis. Despite having normal lung function, the gas diffusion capacity should be controlled in patients with GERD and chronic laryngitis, and it might be the very first abnormality in distal airways.
authors.affiliation: Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Center Zagreb, Zagreb, Croatia.
authors.forename: Mirjana
authors.initials: M
authors.lastname: Mirić
authors.affiliation: Department of Pediatric Allergology and Pulmonology, Children's Hospital Srebrnjak, Reference Center for Clinical Immunology in Children Aappointed by the Ministry of Health and Social Welfare of the Republic of Croatia, Zagreb, Croatia.
authors.forename: Mirjana
authors.initials: M
authors.lastname: Turkalj
authors.affiliation: Department of Pediatric Allergology and Pulmonology, Children's Hospital Srebrnjak, Reference Center for Clinical Immunology in Children Aappointed by the Ministry of Health and Social Welfare of the Republic of Croatia, Zagreb, Croatia.
authors.forename: Boro
authors.initials: B
authors.lastname: Nogalo
authors.affiliation: Department of Pediatric Allergology and Pulmonology, Children's Hospital Srebrnjak, Reference Center for Clinical Immunology in Children Aappointed by the Ministry of Health and Social Welfare of the Republic of Croatia, Zagreb, Croatia.
authors.forename: Damir
authors.initials: D
authors.lastname: Erceg
authors.affiliation: Department of Pediatric Allergology and Pulmonology, Children's Hospital Srebrnjak, Reference Center for Clinical Immunology in Children Aappointed by the Ministry of Health and Social Welfare of the Republic of Croatia, Zagreb, Croatia.
authors.forename: Marija
authors.initials: M
authors.lastname: Perica
authors.affiliation: Department of Pediatric Allergology and Pulmonology, Children's Hospital Srebrnjak, Reference Center for Clinical Immunology in Children Aappointed by the Ministry of Health and Social Welfare of the Republic of Croatia, Zagreb, Croatia.
authors.forename: Davor
authors.initials: D
authors.lastname: Plavec
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003710:Demography; D004058:Diffusion; D050782:Esophageal pH Monitoring; D005260:Female; D005764:Gastroesophageal Reflux / Q000503:physiopathology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008168:Lung / Q000503:physiopathology*; D008297:Male; D012119:Respiration; D012129:Respiratory Function Tests