Gastroesophageal reflux disease: Its importance in ear, nose, and throat practice

• Published in: International journal of pediatric otorhinolaryngology 2006, Vol.70 (1), p.81-88
• Main Authors: Megale, Silvia R.M.C.L., Scanavini, Adriana B.A., Andrade, Eduardo C., Fernandes, Maria Inez Machado, Anselmo-Lima, Wilma T.
• Format: Article
• Language: English
• Subjects: Anti-Allergic Agents - administration & dosage; Anti-Allergic Agents - therapeutic use; Anti-Ulcer Agents - administration & dosage; Anti-Ulcer Agents - therapeutic use; Antiallergic drugs; Antireflux drugs; Asthma - etiology; Asthma - therapy; Child; Child, Preschool; Childhood; Chronic Disease; Cough - etiology; Cough - therapy; Extra-gastroesophageal manifestations; Female; Gastroesophageal Reflux - complications; Gastroesophageal Reflux - physiopathology; Gastroesophageal Reflux - therapy; Gastroesophageal reflux disease; Humans; Infant; Male; Nasal Obstruction - etiology; Nasal Obstruction - therapy; Otitis Media - etiology; Otitis Media - therapy; Otorhinolaryngologic Surgical Procedures; Otorhinolaryngologic symptoms; Pneumonia - etiology; Pneumonia - therapy; Recurrence; Retrospective Studies; Tonsillitis - etiology; Tonsillitis - therapy; Treatment Outcome
• ISSN: 0165-5876; 1872-8464
• DOI: 10.1016/j.ijporl.2005.05.021

Gastroesophageal reflux disease (GERD) has been implicated in various extra-gastroesophageal diseases, especially in the upper and lower airways (atypical GERD). The objective of the present study was to determine the frequency of gastroesophageal and extra-gastroesophageal symptoms in pediatric patients with GERD and their response to the general treatment. A retrospective study was conducted on 45 children of both sexes aged 3 months–12 years with GERD diagnosed by clinical examination and 24 h single-channel pHmetry. The gastroesophageal and extra-gastroesophageal symptoms, the treatment instituted and the response of the patients to the latter were determined. Five symptomatologic groups were identified: gastroesophageal (51.11%), pulmonary (recurrent pneumonia, 40%, and bronchial asthma, 46.67%), chronic cough (64.44%), rhinologic (chronic nasal obstruction, 68.88%, nasal secretion, 55.55%, and nose itching, 46.66%), and pharyngo-otologic (recurrent acute middle ear infection, 35.56%, and recurrent tonsillitis, 24.44%). The response to treatment (antireflux drugs, antiallergic drugs, and surgical procedures) resulted in cure in 24 patients (53.34%), while 21 continued to be symptomatic. The cure rate was 69.56% for the gastroesophageal group, 100% for the recurrent pneumonia group, 80.95% for the bronchial asthma group, 68.96% for the chronic cough group, 83.87% for the chronic nasal obstruction group, 80% for the nasal secretion group, 85.71% for the nose itching group, 100% for the recurrent acute middle ear infection group, and 90.90% for the recurrent tonsillitis group. Total treatment time was 1.8 times longer for the remission of extra-gastroesophageal symptoms. Exclusive antireflux treatment promoted full remission of the otorhinolaryngologic symptoms in 38.89% of patients (nasal—41.17%, recurrent acute middle ear infection—12.5%, and recurrent tonsillitis—18.18%). GERD can cause otorhinolaryngologic symptoms in children and remission of these symptoms can be obtained with antireflux therapy.