P0950 PROLONGED ESOPHAGEAL PH MONITORING IN THE EVALUATION OF GASTROESOPHAGEAL REFLUX IN CHILDREN WITH CHRONIC PULMONARY AND DIGESTIVE DISORDERS

Abstract

Introduction: Children with various clinical aspects of digestive (emesis) and chronic pulmonary (recurrent wheezing, recurrent pneumonia, asthma, laryngitis), disorders are believed to have a high incidence of pathologic gastro esophageal reflux (GER). This situation is the main indication for prolonged esoph-ageal pH monitoring. The aim of this study was to establish the frequency and the ratio of pathologic GER as a risk factor in the development of digestive and chronic pulmonary disorders. Methods: One hundred children with chronic pulmonary and digestive disorders (mean age 4 months - 7 years), underwent 24– hour continuous esophageal pH monitoring with pH meter Digi-trapper with antimonium catheter, the data were analyzed by using Poligram software. All patients underwent examination for medical history, an ENT examination, Rx–thorax. The standard used variables included the reflux index,the number of reflux episodes, the number of reflux episodes longer than 5 minutes, and the longest episode of reflux, an RI greater than 11,9% was considered to be pathologic GER. Results: Thirty (30%) (Mean age 4months– 7 years, average age 3,4 years) of 100 patients had pathologic GER. The authors found correlation between pathologic GER and different chronic digestive and respiratory disorders and identified two groups of patients. - Group A - 6/30 patients (20%) with chronic digestive disorders (recurrent vomiting) - Group B - 24/30 patients with chronic respiratory disorders from which are: - 13/24 patients recurrent wheezing, 5/24 patients – recurrent pneumonia, 1/24 patients nocturnal cough, 2/24 patients bronchial asthma, 2/29 patients with recurrent laryngitis and 1/24 patient laryngomalacia. An RI of 11,9% - 20% was diagnosed in 5 patients / group A and in 18 patients in-group B. The RI ranged from 20 % - 30 % no one patient in-group A and 2 patients in-group B. For the RI greater than 30 % we find 1 patient in-group A and 4 patient in-group B. Conclusion: Gastroesophageal reflux (GER) is implicated in the pathogenesis of chronic cough, wheezing and other respirator disorders. The authors recommend that a pH-study be performed in children with chronic pulmonary or digestiv disorders in childhood. The method of chois for the diagnosis of pathologic GER in this cases should be prolonged esophageal pH monitoring (24 hour pH monitoring).