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The Evaluation of Gastroesophageal Reflux Disease with Esophageal pH Monitorization in Children

Keywords: Children , gastroesophageal reflux , gastroesophageal reflux disease , pH monitorization , treatment

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Abstract:

Introduction: Gastroesophageal reflux disease is named when gastroesophageal reflux becomes symptomatic, influences the life comfort, and results in morbidity. In this study, we aimed to evaluate the patients admitted with GER-associated symptoms with demographic characteristics, 24-hour esophageal pH monitorization results, and responses to different treatment protocols. Materials and Method: The data of patients who admitted to Uludag University Pediatrics Outpatient Clinic between January 2008 and September 2009 with GERD-associated symptoms and underwent esophageal pH monitorization was collected retrospectively. The associations between initial symptoms, 24-hour esophageal pH monitorization results, presence of accompanying disease, sociocultural conditions, and therapy responses were evaluated. Results: Ninety-two patients (37 female, 55 male) were included and mean age was 4.42±4.33 (1 mo-18 years). The frequency of cough, vomiting and abdominal pain at admission were 49.5%, 47.3% and 22% respectively. Esophageal pH monitorization diagnosed GERD in 21 patients (22.8%). The frequency of symptoms in GERD patients who diagnosed with esophageal pH monitorization was; cough (n:15, 33.4%), vomiting (n:11, 25.6%), and abdominal pain (n:5, 22.3%). Among all complaints, cough was found to be significantly associated with GERD (p=0.041). Accompanying neurological disease was present in 13.1% (n:12), immunodeficiency 13.1% (n:12) and bronchial reactivity 13.1% (n:12). Therapy success was achieved in 57.7% of patients. Therapy response were similar with different therapy protocols (proton pump inhibitor+prokinetic+sucralfate, proton pump inhibitor+prokinetic, H2 receptor blocker+sucralfate, proton pump inhibitor+sucralfate, H2 receptor blocker+ prokinetic, monotherapy with proton pump inhibitor or H2 receptor blocker) (p=0.068).Conclusion: GERD is a common childhood disease. Currently, diagnosis and treatment of GERD in children is still controversial. The results of our study revealed no association with therapy success and different treatment regimens, sociocultural status or accompanying disease. The complaint of cough was found to be significantly in association with GERD. (Journal of Current Pediatrics 2009; 7: 130-6)

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