Relationship between infants cow′s milk protein allergy and gastroesophageal reflux disease

Abstract

Objective To investigate the relationship between cow′s milk protein allergy (CMPA) and gastroesophageal reflux disease (GERD) and the prognosis of GERD combined with CMPA. Methods Fifty patients (24 boys and 26 girls) with GERD were enrolled in this study from January 2015 to June 2016 at Department of Pediatrics, Tangdu Hospital of the Fourth Military Medical University.All children were treated with serum milk protein soluble IgE(sIgE) and milk protein avoidance test, and those with positive results of children′s milk protein by provocation test and those with milk serum protein sIgE negative by milk protein provocation tests were diagnosed as CMPA children with GERD according to the CMPA diagnostic criteria and received diet therapy for 1 month and then their blood eosinophil ratio and 24-hour esophageal pH were monitored. Results Twenty-three cases (46%) of 50 children with GERD were diagnosed as CMPA.There was significant difference in clinical symptoms between GERD group and GERD combined with CMPA group (χ2=22.78, P 0.05). For children with GERD combined with CMPA, the patients received dietary treatment for 1 month.There was significant improvement in vomiting, runny nose/wheezing/cough and diarrhea (P 0.05). The proportions of blood eosinophils were decreased after treatment compared with those before treatment [(2.7±1.8)% vs.(8.2±2.7)%, t=10.006, P<0.01]. The results of 5 children′s 24-hour esophageal pH monitoring showed that the reflux index and the number of acid GERD episodes were lower than before, and the difference was all statistically significant before and after(all P<0.05). Conclusions The occurrence of GERD in infants is partly related to CMPA, and the treatment of CMPA can relieve the clinical symptoms of GERD. Key words: Cow′s milk protein allergy; Gastroesophageal reflux disease; Infant