ASSOCIATION OF GASTROESOPHAGEAL REFLUX WITH SEVERE ADENOTONSILLARY HYPERTROPHY
Makaleler > Tam Makale · 2006
Yazarlar: Gokhan Tumgor, Rasit Midilli, Başak DOĞANAVŞARGİL YAKUT, Funda ÇETİN, Tayfun KİRAZLI, Rasit V. Yagci
Journal of Pediatric Gastroenterology and Nutrition, Uluslararası, Wos, 2006, cilt 43
DOI: 10.1002/j.1536-4801.2006.tb13758.x
Özet
Background: Acid reflux based on pH probe studies is commonly found in children and adults with asthma, and is often occult.Combined pH and multichannel impedance studies allow delineation of reflux in more detail.The aim of this study was to describe the pH of reflux episodes, and association with cough episodes.Methods: After IRB approval, data from 80 cases, mean age 7.1 yrs, range 6 mo to 18 yrs; 49 male 38 female with asthma who had impedance studies performed were reviewed.Of these, 59 were performed off medications, 28 on acid suppression.Using NASP-GHAN criteria, 51% of those not on medications had acid GER.All together, they had mean of 21.5 SD 18.7 acid liquid reflux episodes, 14.5 SD 13.2 weak acid and 3.4 SD 6.1 non-acid episodes.Cough episodes were common, and 37.5 % associated with reflux, in the same proportion of acid to weak acid to non-acid.The Symptom association probability, SAP, was positive for 45% of the patients for cough.The relative distribution of acidity of refluxate was similar for infants, preschool and school age and older children.Standard pH analysis had poor correlation with cough.Asthma severity also had a similar distribution of acid, weak acid and non-acid GER episodes.Conclusions: Weak acid and non-acid reflux episodes are almost as common as acid reflux episodes in asthma.Sequential cough within 2 minutes of a reflux episode, with positive SAP index in many, suggests reflux is an important trigger of asthma symptoms.Reflux episodes per day may be more relevant than reflux index in asthma.