Alkaline Gastroesophageal Reflux in Infancy

Abstract

Alkaline gastroesophageal reflux is a rare disorder, although it has been suggested as a cause of esophagitis. However, up to now, there exists no unequivocally accepted diagnostic method for alkaline reflux that can be routinely applied. "Normal ranges" of episodes of pH greater than 7.0-7.5 in asymptomatic as well as in symptomatic infants are proposed. In the asymptomatic infants (n = 83), the mean percentage of time the pH was greater than 7.0 was 1.3 +/- 2.6, and the number of episodes in 24 h with a pH greater than 7.0 was 10.4 +/- 16.4. In the symptomatic group (n = 60), including infants with chronic vomiting, the mean percentage of time the pH was greater than 7.0 was 0.15 +/- 0.5, and the number of episodes with a pH greater than 7.0 was 2.8 +/- 5.5. In all but six infants the percentage of time the pH was greater than 7.5 was less than 0.1. In three of four of these infants (endoscopy was refused by two parents) whose conditions exceeded the cut-off limits, there was a histologically proven esophagitis. To evaluate the proposed "normal" ranges for episodes of pH greater than 7.0 and 7.5, 200 symptomatic children were included in a prospective study. Symptoms were repetitive vomiting (n = 110), excessive crying (n = 53), and chronic respiratory disease (n = 37). Esophagoscopy was performed in 18 babies (9%) because pH monitoring data exceeded the proposed limits for the percentage of time the pH was greater than 7.0.(ABSTRACT TRUNCATED AT 250 WORDS)