Prevalence Of Gastroesophageal Reflux Research Articles

Prevalence of Gastroesophageal Reflux in Children Aged 2–15 Years Old with Chronic Abdominal Pain: 9 Years Experience

Purpose: Gastroesophageal reflux (GER) is one of the most frequent clinical disorders affecting the gastrointestinal tract of infants and children and chronic abdominal pain is one of the hallmarks of this disease. The purpose of this study was to find the prevalence of GER in children with chronic abdominal pain that needed esophagogastroduodenoscopy (EGD) for final diagnosis. Methods: All children aged 2–15 years old suffering from chronic abdominal pain that underwent EGD by the author in the only pediatrics gastroenterology ward in south-western of Iran were reviewed and enrolled in this study. The data obtained from the patients files which are kept in the hospital's archive. Results: During 9 years(1998–2007) totally 1156 patients (599 boys, 557 girls) aged 1.5 months to 15 years with different upper GI tract problems underwent EGD in the gastrointestinal ward of Aboozar Children's Hospital, Jundishapour University of Medical Sciences. There were 804 (69.5%) patients (416 boys, 388 girls) older than 2 years who enrolled in our study. Among this age group, we found 449 cases (239 boys, 210 girls) with chronic abdominal pain needed EGD. When the procedure was performed, the diagnosis of esophagitis due to GER was suspected in 86(19%) patients (49 boy-37 girl) by observing obliteration of the Z- line and was confirmed by histopathological changes in esophageal biopsies. There were 8 cases with Barrett's esophagus all aged more than 6 years with history of suspicious symptoms of GERin infancy and later on. Treatment with prokinetic drugs and PPI or H2 receptor blockers was undertaken. Successful treatment was observed in 96% of all patients 6 months after treatment was initiated and on follow up. Surgical antireflux procedure was performed to patients with no resolution of symptoms after 6 months of therapy. Conclusion: In conclusion, GER in children with chronic abdominal pain beyond infancy is not rare ant tends to be chronic and severe and such patients are at high risk of developing serious complications without early diagnosis and treatment.

Sleep Related Gastroesophageal Reflux

With many medical disorders, it takes decades for investigators to examine their effects on sleep. This is truly the case for gastroesophageal reflux (GER). Gastroesophageal reflux is very common in our population, with 7% of adults experiencing symptoms daily and 20% experiencing symptoms at least weekly.1,2 Since obesity is a predisposing factor for GER, the prevalence of GER prevalence will increase as obesity prevalence reaches epidemic proportions. Currently, sleep related GER is underappreciated from a clinical standpoint.3 Although gastroenterologists were slow to recognize the impact of sleep related GER on daytime functioning, they were insightful enough to recognize the need for 24-hour monitoring when esophageal pH testing was developed in the 1970s.4 Since then, Orr and colleagues have performed multiple experiments examining esophageal acid clearance during sleep using esophageal acid infusions.5,6 Over the past 3 years, research has focused on the impact of GER on sleep itself and on daytime consequences of sleep related GER. The tip of the iceberg was discovered' A national population-based telephone survey of 1000 people with heartburn conducted by the Gallup Organization noted that nighttime heartburn was reported by 79% of respondents; 75% of these reported that heartburn affected their sleep, and 40% believed that nighttime heartburn impaired their daytime functioning.3 Despite having prescription GER medications, only 49% of respondents had adequate control of their GER symptoms. Fass and colleagues examined predictors of heartburn during sleep in the 15,314 subjects of the Sleep Heart Health Study, noting that 25% reported heart-burn during sleep.7 Predictors of heartburn during sleep, using multivariate models include increased body mass index, snoring, sleepiness (as noted on the Epworth Sleepiness Scale), hypertension, asthma, and use of benzodiazepines.7 In this issue of the Journal of Clinical Sleep Medicine, Dickman and colleagues examined 48 subjects with GER symptoms, with 16 subjects undergoing esophageal pH monitoring during polysomnography.8 Disorders of initiating and maintaining sleep were associated positively with GER severity on validated questionnaires. Furthermore, subjects who reported more nighttime awakenings had higher GER symptom scores. This study also gives insight as to when acid GER events occur. Approximately 54% of the GER events occurred during sleep and of those, 62% of GER events were followed by an awakening. Ninety percent of GER events that occurred during sleep were associated with sleep disruption. So, individual GER events do disrupt sleep architecture. Although this study was not specifically designed to answer the question as to whether sleep time events can affect wake time GER, it gives preliminary evidence that it may. Poor sleep did worsen GER the following day. Poorer sleep quality obtained from the Sleep Quality Questionnaire was associated with longer acid GER events.8 This cycle can be stopped because aggressive GER therapy can improve sleep outcomes and daytime functioning as noted by Johnson and colleagues.9 They performed a placebo-controlled trial utilizing esomeprazole 40 mg, 20 mg, or placebo for 6 weeks in 750 adults with GER-associated sleep disturbance. Fifty percent of the esomeprazole-treated subjects had resolution of nighttime heartburn, and by 4 weeks, 73% of the esomeprazole-treated subjects had resolution of their GER-associated sleep disturbance. Both doses of esomeprazole resulted in improved sleep quality, reduced lost work hours, and increased work productivity.9 So now that the tip of the iceberg is exposed and treatment is available, sleep professionals need to inquire about GER symptoms in patients who present with awakenings and/or excessive daytime sleepiness. Many unanswered questions still remain concerning sleep related GER that will require interdisciplinary studies with our gastroenterology colleagues.

Prevalence of BE in Children

The prevalence of Barrett esophagus (BE) in adult patients with gastroesophageal reflux (GER) is about 10%. Because no specific signs or symptoms are known to signal BE development, most adult cases are diagnosed as prevalent, and age at onset is unknown. Estimates of the prevalence of GER in pediatric patients have been derived from small case series, which suggest that it is about 2.3% in 3- to 17-year-old children …

Increased incidence of apparently life‐threatening events due to supine position

Gastro-oesophageal reflux (GOR) has a high prevalence in infancy. The supine position is among numerous aggravating factors. The exact relationship between GOR and apparently life-threatening events (ALTE) is not clear, although it has been repeatedly investigated. In 1992 the worldwide Back to Sleep campaign was implemented, which had a dramatic effect on the incidence of sudden infant death syndrome (SIDS) with a drop of 50%. Although the vast majority of children now sleep on their back, the effect of this position on ALTE has not been studied. In this retrospective study, we aim to define the potential association between GOR and ALTE. We hypothesise that the incidence of ALTE has increased since the 1992 recommendation. No bias in the population's selection was introduced, as our centre is the only one for paediatric emergencies in the county. A total of 107 children presenting with ALTE were identified during the study period (1987-99). A pH study was performed in the 75 patients presenting with ALTE in the last 6 years of the study (1994-99). Neither morbidity nor mortality was noted in a long-term 4-year follow-up. Our present results show that the frequency of ALTE increased sevenfold (P < 0.005) between 1992 and 1999. The ALTE episodes took place significantly more often in the post-prandial period. The prevalence of GOR was much higher in patients presenting with ALTE (nearly 75%) when compared with the general population. Furthermore, on medical treatment for GOR, very few patients presented with a second episode of ALTE. Consequently it is thought that GOR and ALTE are linked and that ALTE patients would benefit from GOR treatment. The worldwide marked decrease in SIDS since the implementation of the supine position possibly masks the negative effect of an increase in ALTE.

Repeated Pneumatic Dilations as Long-Term Maintenance Therapy for Esophageal Achalasia

In esophageal achalasia, pneumatic dilations (PD) provide short-term and long-term remission rates of 60-90% and 40-50%, respectively. The aim of this study was to evaluate the long-term efficacy of repeated PD as long-term maintenance therapy. From 1992 to 2004, 150 patients with esophageal achalasia treated by PD were included in this retrospective study (78 males, mean age 57 +/- 20 yr). PD were performed until remission was achieved (symptom score < or = 3, each item < 2) and subsequently when symptomatic recurrence occurred. A standardized symptoms questionnaire was sent to patients lost to follow-up. Results are expressed as mean +/- SD. Initial remission was achieved in 137 of 150 (91.3%) patients with 2.67 +/- 1.59 dilations [range 1-12]. Failure and perforation rates were 7.3% (n = 11) and 1.3% (n = 2), respectively. After initial remission, 48 of 137 (35%) patients had recurrent symptoms; the probability to be in remission at 5 and 10 yr was 67% and 50%, respectively. At the end of follow-up (45 +/- 38 months, ext. 2-144) 108 of 137 (78.8%) patients were in remission. Among 112 patients whose symptoms could be treated by repeated PD (per protocol analysis), 108 (96.4%) were in remission (3.5 +/- 2.1 PD, ext. 2-12). In this group, the probability of being in remission after repeated PD at 5 and 10 yr was 96.8% and 93.4%, respectively. No pretherapeutic factor influenced long-term remission rate. The overall prevalence of gastroesophageal reflux was 34.7%. One-third of the patients with esophageal achalasia treated by PD will experience symptomatic recurrence during a 4-yr period. Long-term remission can be achieved in virtually all the patients treated by repeated PD according to an "on-demand" strategy based on symptom recurrence.

Gastroesophageal Reflux (GER) Is Highly Prevalent in Asymptomatic Patients Awaiting Lung Transplantation

Gastroesophageal Reflux (GER) Is Highly Prevalent in Asymptomatic Patients Awaiting Lung Transplantation Kalyani Maganti, Connie Wigen, Lorinda Dollison, Juan C. Garcia Background: Bronchiolitis obliterans and its clinical correlate bronchiolitis obliterans syndrome are a major cause of morbidity and mortality following lung transplantation. Aspiration secondary to GER has been postulated to be a contributing factor. GER has also been shown to worsen following lung transplantation. Preoperative recognition would help anticipate management in these patients. Methods: A retrospective study was performed to determine the prevalence of GER in 14 consecutive end-stage lung disease patients being evaluated for lung transplantation. 12 had dual-channel esophageal 24-hour pH while 1 patient had BRAVO capsule testing. 13 patients underwent esophageal manometry. Results: Among the 14 patients, indications for lung transplant were as following: 6 emphysema, 3 idiopathic pulmonary fibrosis, 1 cystic fibrosis, 1 pulmonary hypertension, and 1 alpha 1 antitrypsin deficiency. 12 patients were asymptomatic for GER on presentation while 2 had heartburn. The lower esophageal sphincter was hypotensive in 9 (76%) patients with a mean lower esophageal sphincter pressure of 9.5 mm Hg. 4 (30%) had esophageal body dysmotility. Among those 2 had low amplitudes with ineffective esophageal motility, likely secondary to GER as evidenced by abnormal pH study, and 2 had nutcracker esophagus, one of whom had a positive DeMeester score. The overall DeMeester score was above normal in 9 (69%) patients with a mean score of 64.4 (normal !14.72). 7 (53%) were noted to have abnormal proximal acid exposure with a mean of 8.3% (normal !1.3% exposure). 9 (69%) had abnormal distal acid exposure with a mean of 18.4% (normal !4% exposure). Conclusions: GER is highly prevalent in end-stage lung disease patients and can be clinically silent. We conclude that all patients undergoing evaluation for lung transplantation, irrespective of symptoms, should be routinely investigated for GER in view of its possible contribution to allograft dysfunction.

Prevalence of Gastroesophageal Reflux in Difficult Asthma: Relationship to Asthma Outcome

Prevalence of Gastroesophageal Reflux in Difficult Asthma: Relationship to Asthma Outcome

Prevalence of Gastroesophageal Reflux in Difficult Asthma: Relationship to Asthma Outcome

Prevalence of Gastroesophageal Reflux in Difficult Asthma: Relationship to Asthma Outcome

Prevalence of Gastroesophageal Reflux in Native Americans

Prevalence of Gastroesophageal Reflux in Native Americans

The Role of (Duodeno)gastroesophagopharyngeal Reflux in Unexplained Excessive Throat Phlegm

Gastroesophageal reflux (GER), through the occurrence of gastroesophagopharyngeal reflux (GEPR), is an established cause of several otorhinolaryngological (ORL) manifestations. It has been suggested that unexplained excessive throat phlegm might also be a manifestation of GER, but formal evidence is lacking. The aim of the present study was to investigate the prevalence of GER as well as duodenogastroesophageal reflux (DGER) in consecutive patients with chronic complaints of excessive throat phlegm. Fifty-nine consecutive patients with chronic unexplained excessive throat phlegm, transparent in 33 patients (TTP) and yellow in 26 patients (YTP), underwent gastrointestinal endoscopy, 24-hr dual esophageal pH monitoring, and fiberoptic DGER monitoring. Proximal esophageal DGER monitoring was performed in seven YTP patients and analysis of bile acids in throat phlegm was performed on 16 samples. The effect of high-dose acid suppressive therapy was evaluated at 2-week intervals. Endoscopy and pH monitoring established a diagnosis of pathological GER in 75% of the patients. Pathological DGER was present in 56% of the patients and this was associated with YTP. Proximal DGER exposure was high in all investigated subjects and chemical analysis revealed a median bile acid concentration of 0.184 microM in nine YTP samples and no detectable bile acids in seven TTP samples. After a median of 4 weeks of acid suppressive therapy, most patients improved and 61% became asymptomatic. YTP patients were more likely to require maintenance acid suppressive therapy than TTP patients. Unexplained excessive throat phlegm is a sign suggestive of GER and GEPR, and unexplained yellow throat phlegm a sign suggestive of duodenogastroesophagopharyngeal reflux (DGEPR).

Gastroesophageal Reflux in Familial Dysautonomia: Correlation with Crisis Frequency and Sensory Dysfunction

Familial dysautonomia (FD), a genetic disorder resulting in sensory and autonomic nervous system dysfunction, is associated with a high frequency of gastroesophageal reflux (GER). In this study the authors attempted to determine if GER prevalence correlated with dysautonomic crisis frequency and small fiber sensory dysfunction. Of an initial population of 252 FD patients who had survived past their seventh year and were alive during the year of study from June 1, 2001 to June 1, 2002, 174 (69.0%) had sufficient data in their patient files to be included in this retrospective analysis. Subjects were stratified into three groups: those with no GER, those medically treated for GER and those surgically treated for GER with fundoplication. Data were obtained regarding frequency and severity of dysautonomic crises and sensory function including pain sensation, cold and warm thresholds and vibration perception. There were no significant differences among the three groups regarding age or severity of sensory dysfunction. However, dysautonomic crises were significantly more frequent in FD patients who were presumed to have more intractable GER, as they had required fundoplication (P < 0.05). The data confirm the high incidence of GER in the FD population and demonstrate that GER is independent of severity of sensory dysfunction. In addition, the authors demonstrate that fundoplication does not alleviate the central autonomic cause of retching, the dysautonomic crisis.

Gastroesophageal Reflux in the Preterm Neonate

After completing this article, readers should be able to: 1. Describe the epidemiology and pathophysiology of gastroesophageal reflux (GER) in preterm neonates. 2. Delineate the associations of GER with apnea, chronic lung disease, behavior, and growth of preterm infants. 3. Review the investigations used to evaluate GER in preterm infants. 4. Describe nonpharmacologic and pharmacologic therapies for GER. Gastroesophageal reflux (GER) is a normal physiologic event occurring across the age spectrum. It may contribute to a variety of disorders, including esophagitis, feeding problems, and airway disease in all age groups. (1) A large number of symptoms and signs have been purported to be caused by GER despite a lack of data showing a clear association between a specific symptom and GER. In preterm infants, empiric therapy often is administered using agents of unproven efficacy and safety to treat symptoms that likely are unrelated to GER. In a survey on management practices for GER in preterm infants, common treatment strategies included positioning (98%) and slopes (96%), histamine 2 (H 2) receptor antagonists (100%), feed thickeners (98%), antacids (96%), prokinetics (79%), proton pump inhibitors (PPIs) (65%), and dopamine receptor antagonists (53%). (2)(3) The safety, efficacy, and appropriate dosing recommendations for most medical therapies remain uncertain in neonates. In this review, we attempt to summarize the current literature regarding physiology, pathophysiology, and diagnostic and management strategies for GER pertinent to the neonate, with an emphasis on the preterm infant. GER describes the retrograde movement of stomach contents (air or feeding, liquid or semisolid, acid or alkaline, enzymes or bile salts) into the esophagus. GER disease (GERD) occurs when GER causes symptoms or signs such as pain, poor weight gain, esophagitis, hematemesis, and airway symptoms, including apnea, aspiration, recurrent pneumonia, chronic lung disease (CLD), or large airway inflammation. However, any of these symptoms or signs …

Persistent cough: Prevalence of gastroesophageal reflux and study of relevant laryngeal signs

Cough is one of the atypical manifestations of gastroesophageal reflux disorder (GERD). The aim of this study was to evaluate the prevalence of GERD among patients presenting with persistent cough. The study included 80 patients over a period of 3 years. The inclusion criteria were nonsmoker adults with normal chest radiograph whose chief complaint was cough for at least 4 weeks duration. All patients included were subjected to nasal endoscopy, laryngoscopy, and 24-hour pH monitoring. Reflux was recorded in the different positions. Laryngeal signs of reflux were traced for and their significance was calculated. Patients who proved to have GERD received antireflux treatment with a follow-up of 3 months. The response to antireflux treatment was assessed according to subjective and objective improvement. Relapse in the follow-up period occurred in 9% of patients. It is concluded that laryngeal signs of GERD should be well known to diagnose and properly manage persistent cough.

P0981 GASTROESOPHAGEAL REFLUX IN CHILDREN WITH PERSISTENT ASTHMA: CORRELATION WITH PULMONARY FUNCTION TEST

Introduction: The relationship of cause and effect between gastroesophageal reflux (GER) and asthma is not well known. Recent studies have shown high prevalence of GER in children with asthma; however, with different results of correlation with pulmonary function. This study aimed to evaluate the prevalence of GER in children with persistent asthma and to compare the symptoms of GER, intraesophageal pH studies and pulmonary function tests in children with and without GER. Methods: Thirty eight patients from 5 to 15 years of age were evaluated. All patients had diagnosis of asthma according to NIH guidelines,19971 and were chronically using medicatons for asthma control such as inhalated corticosteroids or leucotriens. Prolonged intraesophageal pH-study (Digitrapper MKIII, Synetics, Sweden) and espirometry (Jaeger Flow Pro, Erich Jaeger GmbH, Germany) were performed in all patients. Positive pH-study for GER was defined as total reflux index (RI) more than 5%. Pulmonary function was evaluated by measuring FVC (forced vital capacity), FEV1 (forced expiratory volume in 1 second) and FEF25–75% (midexpiratory flow rate). Results: Median (range) age was 10 (5–15) years old and 23 (59%) patients were male. Prevalence of GER was 47.3%. The patients were divided in 2 groups according to pH-study: group I-asthma and GER (n=18); group II-asthma without GER (n=20). There was no significant difference of gastrointestinal symptoms such as vomiting and abdominal pain between groups I and II. Fifty percent of patients from group I did not have any symptom of GER. Regarding the results of pulmonary function tests, only FEF25–75% was <75% of predicted value without significant difference (group I: 66.8%, group II 56.8%, p: 0.34). From all patients, the coefficient of correlation between RI and CVF was r: −0.17 (p 0.28); RI and VEF1 was r:–0.17 (p 0.29), and RI and FEF 25–75 was r:–0.10 (p 0.54). Conclusion: Gastroesophageal reflux had high prevalence among children with persistent asthma; however, without significant correlation between alterations of pH-study and pulmonary function test. GER might be considered in pediatric patients with persistent asthma, even in the absence of gastrointestinal symptoms.

P0837 DYSPEPTIC PAIN ABDOMEN IN CHILDREN: H. PYLORI OR REFLUX ESOPHAGITIS

Introduction: Recurrent Abdominal Pain (RAP) is a common symptom in children. It has been widely reported to affect at least 10% of children over the age of 3 years. It has many etiologies and varied presentations. Previously organic causes could be identified in fewer than 10% cases and pain in most patients was attributed to functional disorders. With investigative modalities, more organic lesions are being detected. One of these, particularly in recent years is the identification of H. pylori in children with RAP. While some investigators have shown improvement in symptoms with eradication of H. pylori others have not been able to demonstrate any significant benefit. Therefore, currently there are no guidelines on whether or not to treat the infection. One of the presentations of RAP in children is dyspepsia. While dyspepsia has been well described in adult medicine, it has been rather poorly studied in the Pediatric population. In adults, gastroesophageal reflux and reflux esophagitis are well recognized among the disorders causing dyspepsia. This aspect also has not been well documented in children. This study was aimed at studying the prevalence of dyspeptic symptoms in children with recurrent abdominal pain, and the prevalence of gastroesophageal reflux and H. pylori in these dyspeptic children. Methods: 100 children with RAP were enrolled. After excluding 18 children with organic pathology, all children of recurrent abdominal pain with dyspeptic symptoms (35) and remaining without dyspeptic symptoms (47) were taken up for 24 hours esophageal pH monitoring and upper GI Endoscopy with Biopsy. Results: 14 (43.7%) had evidenc of H. Pylori in dyspeptic group as opposed to 22 (55%) in non dyspeptics (p>0.05). Amongst 32 dyspeptics in whom 24 - hour pH monitoring was done 24 (75%) had evidence of reflux. Amongst 45 non-dyspeptics in whom 24 hour pH monitoring was done 40 (88.8%) had no evidence of reflux (p<0.01). Amongst 21 children with Reflux Index (RI) > 5, 13 (65%) children had histologically proved esophagitis. Conclusion: Presence of H. Pylori in gastric biopsy could not be co-related with occurrence of dyspeptic symptoms in the present study. On the other hand gastroesophageal reflux and reflux esophagitis seem to be fairly common in children with dyspeptic symptoms. Thus children with dyspeptic symptoms may be given a trial of antio reflux therapy if facilities for endoscopy or 24 hour pH monitoring are not available. Reference(s) truncated . . .

Esophageal pH study and symptomatology of gastroesophageal reflux in newborn infants.

A retrospective study was undertaken to assess the association between esophageal pH monitoring variables and signs such as regurgitation, vomiting, apnea, bradycardia, and cyanotic episodes attributable to gastroesophageal reflux (GER) in neonates. One hundred thirty-four infants with one or more of the above-described signs underwent 24-hour distal esophageal pH monitoring in the neonatal intensive care unit, and were divided into 2 groups by gestational age. Group 1 (preterm infant group) consisted of infants aged 25 to 36 weeks of gestation ( n = 45) and group 2 (term infant group) consisted of infants aged 37 to 42 weeks gestation ( n = 89). Esophageal pH monitoring variables were compared by gestational age group and within preterm infants by theophylline treatment and, separately, by nasogastric tube using the Mann-Whitney U test. Comparisons of nominal data were made using the chi square test. Logistic regression analysis was used to assess the net effect of each independent variable on the risk of developing GER. The prevalence of GER was not influenced by gestational age. The prevalence of gastrointestinal signs did not differ between groups. Cardiorespiratory signs attributed to GER were more frequent in preterm infants than in term infants. The number of episodes with pH < 4 in 24 hours was greater in the term compared with the preterm infant groups. Logistic regression analysis failed to detect an association between acid GER and gestational age, apnea, bradycardia, cyanotic episodes, vomiting, or regurgitation. Theophylline treatment and the presence of a nasogastric tube did not significantly affect the esophageal pH monitoring variables in preterm infants. Preterm infants have a smaller number of reflux episodes compared with term infants. In addition, treatment with theophylline for apnea of prematurity and the presence of a nasogastric tube in preterm infants did not significantly affect pH-monitoring variables in preterm infants.

Gastroesophageal Reflux

To study the incidence of gastroesophageal reflux (GER)related complications after correction of esophageal atresia (EA). The association of EA and GER in children is well known. However, little is known about the prevalence of GER and its potential complications in adults who have undergone correction of EA as a child. Prospective analysis of the prevalence of GER and its complications over 28 years after correction of EA by means of a questionnaire, esophagogastroscopy, and histologic evaluation of esophageal biopsies. The questionnaire was returned by 38 (95%) of 40 patients. A quarter of the patients had no complaints. Swallowing solid food was a problem for 13 patients (34%), and mashed foods for 2 (5%). Heartburn was experienced by 7 patients (18%), retrosternal pain by 8 (21%). However, none of the patients were using antireflux medication. Twenty-three patients (61%) agreed to undergo esophagogastroscopy, which showed macroscopic Barrett esophagus in 1 patient, which was confirmed by histology. One patient developed complaints of dysphagia at the end of the study. A squamous cell esophageal carcinoma was diagnosed and treated by transthoracic subtotal esophagectomy. This study shows a high incidence of GER-related complications after correction of EA, but it is still very disputable if all EA patients should be screened at an adult age.

Outcomes of Pediatric Gastroesophageal Reflux Disease: In the First Year of Life, in Childhood, and in Adults . . . Oh, and Should We Really Leave Helicobacter pylori Alone?

ABSTRACTThe prevalence of gastroesophageal reflux (GER) in childhood varies by age. As in adults, GER can result in a spectrum of disease manifestations. Children with gastroesophageal reflux disease (GERD) may become adults with GERD, as suggested by the frequency of childhood reflux symptoms reported by adults with reflux disease. Some studies suggest a causative association between Helicobacter pylori infection and GERD, whereas others postulate a protective role for H. pylori. To better understand pediatric GERD, age‐appropriate case definitions and multicenter randomized controlled treatment trials are critically needed.

Outcomes of pediatric gastroesophageal reflux disease: in the first year of life, in childhood, and in adults...oh, and should we really leave Helicobacter pylori alone?

The prevalence of gastroesophageal reflux (GER) in childhood varies by age. As in adults, GER can result in a spectrum of disease manifestations. Children with gastroesophageal reflux disease (GERD) may become adults with GERD, as suggested by the frequency of childhood reflux symptoms reported by adults with reflux disease. Some studies suggest a causative association between Helicobacter pylori infection and GERD, whereas others postulate a protective role for H. pylori. To better understand pediatric GERD, age-appropriate case definitions and multicenter randomized controlled treatment trials are critically needed.

Esophageal reflux in older patients with noncardiac chest pain

Purpose: Gastroesophageal Reflux (GER) has been commonly recognized in young and middle-aged patients with noncardiac chest pain (NCCP). GER prevalence rates are higher in older patients with typical presentation forms of the disease. There is paucity of information regarding the prevalence of GER in older patients with atypical forms of GER, i.e. NCCP. It is also unknown whether there are any differences in clinical presentations (heartburn/regurgitation) between young patients with NCCP and their elderly counterparts. HYPOTHESIS: GER is more prevalent in older than in younger patients with NCCP. AIM: Evaluate if there are differences in the prevalence rates of GER in our patient population with NCCP based on their age.