Long-lasting reflux episodes in gastroesophageal reflux and its complications in children

Abstract

Background/aims: The aim of the study was to test the hypothesis that long-lasting reflux episodes (episodes longer than 5 minutes and longest reflux episode) are more and are longer in patients with complicated gastroesophageal reflux (GER), such as reflux esophagitis, etc.

Material and methods: In a prospective study 120 children (age 2 months to 14 years) were evaluated for the presence of GER and its complications (respiratory disease, reflux esophagitis). Out of them 51 were without GER (control group). With functional GER were 17, respiratory disease and GER had 21, and RE 16. Diagnosis of GER was established by computed 24 hour pH monitoring (C24hpHM) using Digitrapper Mark III, Synectics, Sweden. GER was positive if pH<4 was >5% of investigated time. Number of reflux episodes (NRE), episodes longer than 5 minutes (EL5), the longest reflux episodes (LRE), reflux index (RI) and duration of investigation were considered for the purpuse of this study.

Results: There was no significant statistical difference for the duration of procedure between the groups (Kruskal-Wallis test p>0.05). There was significant statistical difference for all parameters between control group and group with RE (Kruskal-Wallis test p<0.05). In RE patients there was significantly higher number of EL5, and longer duration of LRE compared with uncomplicated GER, functional GER, and GER with respiratory disease (Kruskal-Wallis test p<0.05). Between respiratory disese and functional GER there was no significant statistical difference. There was significant statistical difference between mild and severe RE for EL5 and LRE (Kruskal-Wallis test p<0.05).

Conclusion: We confirmed that long lasting reflux episodes (EL5, LRE) are significantly higher in number and longer duration in children with RE, and together with acid reflux area, and impaired esophageal clearance contribute to development of RE.