S266 – Review of Endoscopic Findings in Children with GERD

Abstract

Objectives Many children with gastroesophageal reflux will initially present with respiratory symptoms including cough, stridor, increased work of breathing, apneic events, and recurrent episodes of croup. Despite a growing body of literature that suggests a correlation between airway pathology and GERD, there still remains much controversy. Our objective is to systematically review published literature correlating findings on endoscopic evaluation of the larynx and trachea in the pediatric population with the incidence of gastroesophageal reflux disease. Methods A systematic review was performed of 19 articles relating the presence of gastroesophageal reflux disease in the pediatric population to findings on endoscopic airway evaluation. These were identified through a structured PubMed search of English language literature using the key terms laryngopharyngeal reflux, extraesophageal reflux, and gastroesophageal reflux. Only those articles studying endoscopic findings in the pediatric population were included. Results All studies evaluated the subjects for the presence of gastroesophageal reflux. The most commonly utilized methods of diagnosis include barium esophagram, video fluoroscopy, gastric scintiscan, 24 hour pH probe, and esophageal biopsy. Arytenoid, postglottic and vocal fold edema and erythema, lingual tonsil hypertrophy, laryngomalacia, and subglottic stenosis are among the endoscopic findings most frequently identified in disease-positive patients. Conclusions Certain commonly encountered findings on endoscopic evaluation of the larynx and trachea performed in children presenting with respiratory symptoms do indeed demonstrate a correlation with presence of gastroesophageal reflux and may indicate that antireflux therapy should be considered in the treatment of this population of patients.