title: Gastroesophageal Reflux in Neurologically Impaired Children: What Are the Risk Factors?
abstract: OBJECTIVE
  Neurologically impaired patients frequently suffer from gastrointestinal tract problems, such as gastroesophageal reflux disease (GERD). In this study, we aimed to define the risk factors for GERD in neurologically impaired children.
  
  
  METHODS
  From May 2006 to March 2014, 101 neurologically impaired children who received 24-hour esophageal pH monitoring at Severance Children's Hospital were enrolled in the study. The esophageal pH finding and the clinical characteristics of the patients were analyzed.
  
  
  RESULTS
  The reflux index was higher in patients with abnormal electroencephalography (EEG) results than in those with normal EEG results (p=0.027). Mitochondrial disease was associated with a higher reflux index than were epileptic disorders or cerebral palsy (p=0.009). Patient gender, feeding method, scoliosis, tracheostomy, and baclofen use did not lead to statistical differences in reflux index. Age of onset of neurological impairment was inversely correlated with DeMeester score and reflux index. Age at the time of examination, the duration of the disease, and the number of antiepileptic drugs were not correlated with GER severity.
  
  
  CONCLUSIONS
  Early-onset neurological impairment, abnormal EEG results, and mitochondrial disease are risk factors for severe GERD.
authors.affiliation: Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Seung
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hong
authors.initials: H
authors.lastname: Koh
authors.affiliation: Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Joon Soo
authors.initials: JS
authors.lastname: Lee
mesh_terms: D002493:Central Nervous System Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D002547:Cerebral Palsy / Q000150:complications; D002675:Child, Preschool; D004569:Electroencephalography; D004827:Epilepsy / Q000150:complications; D050782:Esophageal pH Monitoring; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007223:Infant; D008297:Male; D028361:Mitochondrial Diseases / Q000150:complications; D012307:Risk Factors
keywords: Child; Esophageal pH monitoring; Gastroesophageal reflux