GASTROESOPHAGEAL REFLUX IN CHILDREN WITH CHRONIC RECURRENT BRONCHOPULMONARY INFECTION

To evaluate the role of gastroesophageal reflux (GER) as a possible cause of recurrent bronchopulmonary infection in Chinese children, 23 patients were studied prospectively with 24-h pH monitoring. Their ages ranged from 3 to 25 months. The patients studied were chosen by the criterion of repeated, radiographically documented bronchopulmonary infection with a frequency of two or more episodes in the most recent 6 months, or a single episode with a protracted course longer than 3 months. Twenty-one of the 23 showed abnormal GER on 24-h pH monitoring. Twenty children received medical therapy, 17 of whom were followed regularly for 14-29 months. Eleven had subsidence or improvement of symptoms at follow-up. Follow-up pH monitoring was performed in 5 of the 11 patients, and showed improvement. Six failed to show improvement with medical therapy. Follow-up pH monitoring revealed increased reflux in two of them. Three of the six received fundoplication and had marked improvement of reflux and symptoms postoperatively. Clinical resolution corresponded well to 24-h pH monitoring. GER may be considered one of the possible contributing factors in any child with chronic recurrent bronchopulmonary infection, and antireflux therapy might be beneficial. Twenty-four hour pH monitoring was the best single test for diagnosing GER and determining the severity of the disease.