title: Pilot study: Association between Helicobacter pylori in adenoid hyperplasia and reflux episodes detected by multiple intraluminal impedance in children.
abstract: OBJECTIVE
  The aim of this pilot study was to investigate an association between laryngopharyngeal reflux detected by combined multiple intraluminal impedance and pH monitoring and Helicobacter pylori in adenoid hyperplasia detected with real time polymerase chain reaction (PCR).
  
  
  METHODS
  The study group consisted of 30 children (median age 5.34 years) with extraesophageal symptoms of gastroesophageal reflux disease with adenoid hyperplasia. All children underwent adenoidectomy with subsequent PCR detection of H. pylori DNA in the tissue and multiple intraluminal impedance and pH monitoring. The most proximal impedance sensor was located 1cm caudal to the entrance of the oesophagus.
  
  
  RESULTS
  We found significant differences in the number of reflux episodes among patients with PCR positivity (median 35) and negativity (median 0) of H. pylori (p-value of Mann-Whitney U-test 0.0056). Patients with PCR positivity of H. pylori had significantly more reflux episodes reaching the upper oesophageal sphincter (p-value of Mann-Whitney U-test 0.023). The absence of reflux episode was the only independent factor for PCR negativity of H. pylori in the multiple logistic regression model.
  
  
  CONCLUSIONS
  These results support the hypothesis that reflux episodes reaching the upper oesophageal sphincter may play an important role in the transmission of H. pylori into lymphoid tissue of the nasopharynx and thus may contribute to adenoid hyperplasia in children.
authors.affiliation: Department of ENT, 2nd Faculty of Medicine, University Hospital Motol, Charles University, Prague, Czech Republic. Electronic address: rami.katra@centrum.cz.
authors.forename: R
authors.initials: R
authors.lastname: Katra
authors.affiliation: Department of ENT, 2nd Faculty of Medicine, University Hospital Motol, Charles University, Prague, Czech Republic.
authors.forename: Z
authors.initials: Z
authors.lastname: Kabelka
authors.affiliation: Department of ENT, 2nd Faculty of Medicine, University Hospital Motol, Charles University, Prague, Czech Republic.
authors.forename: M
authors.initials: M
authors.lastname: Jurovcik
authors.affiliation: Department of Paediatrics, 2nd Faculty of Medicine, University Hospital Motol, Charles University, Prague, Czech Republic.
authors.forename: O
authors.initials: O
authors.lastname: Hradsky
authors.affiliation: Department of Otorhinolaryngology, Hospital Rudolph and Stephanie, Benešov, Czech Republic.
authors.forename: J
authors.initials: J
authors.lastname: Kraus
authors.affiliation: Department of Microbiology and Immunology and Institute of Medical Biochemistry and Laboratory Medicine, 1st Faculty of Medicine, General Faculty Hospital, Charles University, Prague, Czech Republic.
authors.forename: E
authors.initials: E
authors.lastname: Pavlik
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, University Hospital Motol, Charles University, Prague, Czech Republic.
authors.forename: E
authors.initials: E
authors.lastname: Nartova
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, University Hospital Motol, Charles University, Prague, Czech Republic.
authors.forename: P
authors.initials: P
authors.lastname: Lukes
authors.affiliation: Department of ENT, 3rd Faculty of Medicine, Charles University, Military University Hospital, Prague, Czech Republic.
authors.forename: J
authors.initials: J
authors.lastname: Astl
mesh_terms: D000234:Adenoids / Q000382:microbiology* / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D004269:DNA, Bacterial / Q000302:isolation & purification; D017097:Electric Impedance; D050782:Esophageal pH Monitoring; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis*; D016480:Helicobacter pylori / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D006965:Hyperplasia; D057045:Laryngopharyngeal Reflux / Q000175:diagnosis*; D008297:Male; D010865:Pilot Projects; D060888:Real-Time Polymerase Chain Reaction
chemical_list: D004269:DNA, Bacterial
keywords: Adenoid hyperplasia; Helicobacter pylori; Laryngopharyngeal and gastroesophageal reflux; Multiple intraluminal impedance; PCR