The link between airway reflux and non-acid reflux in children: a review

• Published in: Brazilian journal of otorhinolaryngology 2023-03, Vol.89 (2), p.329-338
• Main Authors: Saniasiaya, Jeyasakthy, Kulasegarah, Jeyanthi
• Format: Article
• Language: English
• Subjects: Airway reflux; Child; Children; Electric Impedance; Esophageal pH Monitoring; Gastroesophageal reflux; Gastroesophageal Reflux - complications; Gastroesophageal Reflux - diagnosis; Humans; Laryngopharyngeal reflux; Laryngopharyngeal Reflux - complications; Laryngopharyngeal Reflux - diagnosis; Non-acid reflux; OTORHINOLARYNGOLOGY; Prospective Studies; Retrospective Studies; Review
• ISSN: 1808-8694; 1808-8686; 1808-8686
• DOI: 10.1016/j.bjorl.2022.05.002

•Airway reflux, a form of extra-esophageal reflux, has been linked to countless respiratory pathologies amongst children.•Review of the literature revealed that non-acid reflux is the culprit behind airway reflux and other myriads of extra-esophageal manifestations in children.•Non-acid reflux explains the exasperation faced by numerous otorhinolaryngologists following the futile outcome of devout usage of acid suppression in children to treat airway reflux.•A recent surge in the implementation of multichannel intraluminal impedance monitoring amongst children has enabled the discovery of non-acid reflux.•Multicentre international studies with a standardized protocol could improve scientific knowledge in managing non-acid reflux in airway reflux amongst children. Airway reflux, a member of extra-esophageal reflux, has been linked to countless respiratory pathologies amongst children. The advent of novel instrumentation has enabled the discovery of non-acid reflux which was postulated as the main culprit of airway reflux. The objective of this review is to outline the association between non-acid reflux and airway reflux in children. A comprehensive review of recent literature on non-acid reflux and airway reflux in children was conducted. Studies ranged from January 2010 till November 2021 were searched over a period of a month: December 2021. A total of eleven studies were identified. All studies included in this review revealed a strong link between non-acid reflux and airway reflux in children. 6 of the included studies are prospective studies, 3 retrospective studies, 1 cross-section study, and type of study was not mentioned in 1 study. The most common reported respiratory manifestation of non-acid reflux in children was chronic cough (7 studies). Predominant non-acid reflux was noted in 4 studies. The total number of children in each study ranges from 21 to 150 patients. MII-pH study was carried out in all studies included as a diagnostic tool for reflux investigation. Non-acid reflux is the culprit behind airway reflux as well as other myriads of extra-esophageal manifestations in children. Multicentre international studies with a standardized protocol could improve scientific knowledge in managing non-acid reflux in airway reflux amongst children.