Clinical ScienceExtraesophageal associations of gastroesophageal reflux disease in children without neurologic defects☆,☆☆,★
Section snippets
Data sources
TCH is the largest children's hospital in the United States. We used the administrative database at TCH, which contains medical diagnoses obtained at all inpatient and outpatient encounters; these diagnoses are coded according to the 9th revision of the International Classification of Disease, Clinical Modification (ICD-9 CM),23 and the Current Physician's Terminology (CPT) codes.24
Cases
We identified all patients at TCH with GERD (ICD-9 CM codes 530.81, 530.10, 530.11, 530.19, and 530.3) between
Demographic characteristics
Between October 1996 and October 2000, we identified GERD in 1980 children without neurologic defects or congenital esophageal anomalies. During the same time, 7920 children without neurologic defects or congenital esophageal anomalies and without GERD were randomly assigned as controls. All cases and controls were older than 2 (and younger than 18) years. The average age of cases (9.16 years) was slightly greater than that of controls (8.64 years; P < 0.0001). There were significantly more
Discussion
This is by far the largest study to evaluate the association between GERD and respiratory disorders in children without neurologic defects or congenital esophageal anomalies. The results have shown the frequency of sinusitis, laryngitis, asthma, pneumonia, and bronchiectasis to be 2–6-fold higher among children with GERD than among controls. The risk of having these conditions in children with GERD remained significantly elevated after controlling for age, sex, and ethnicity.
Approximately one
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2016, Annals of Allergy, Asthma and ImmunologyCitation Excerpt :One of the most commonly accepted hypotheses is that GERD provides a direct insult to the upper respiratory tract mucosa via reflux of gastric acid. This hypothesis was first suggested on the basis of studies reporting an association between upper respiratory tract inflammation and GERD in children.25–27 In one study, pH recordings in patients with refractory CRS revealed increased reflux events into the nasopharynx in CRS.
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Supported in part by a grant from Eisai Inc. and Janssen Pharmaceutica (to H.B.E.).
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Address requests for reprints to: Hashem B. El-Serag, M.D., M.P.H., Houston Veterans Affairs Medical Center (152), 2002 Holcombe Boulevard, Houston, Texas 77030. e-mail: [email protected]; fax: (713) 748-7359.
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Dr. El-Serag is the recepient of a VA HSR&D Career Development Award (RCD00-013-2). Dr. Rabeneck is the recipient of a National Institutes of Health career award (DK 59318).