Tekrarlayan Solunum Sistemi Semptomları ve Gastrointestinal Yakınmaları Olan Çocuklarda Hipofaringeal Reflülerin Karşılaştırılması

Objective: Recurrent pneumonia and reactive airway symptoms associated with gastroesophageal reflux are well defined clinical entities. The aim of this study is to determine hypopharyngeal reflux among children with suspected gastrooesophageal reflux symptoms and to compare the results between a group of gastrointestinal system disorders and a group of respiratory complaints. Methods: Eighty six children underwent esophageal and hypopharyngeal monitoring. Hypopharyngeal reflux detected through 24 hours of pH monitorisation by double sensor probes to reveal gastric content reaching to the proximal side of oesophagus and contact to respiratory tract. The first group consisting 55 patients had only respiratory complaints and the second group was composed of 31 patients with gastrointestinal symptoms only. pH data for 24 hours from proximal and distal oesophagus of each each group was compared. Results: Eighty six cases who were 1.1 to 17 years old are evaluated. Pathological reflux to the distal oseophagus was determined in 54 % of the patients in group 1 and in 61% of the patients in group 2. Pathological values in 40% of group 1 and in 54 % of group 2 were assessed at hypopharyngeal monitorisation. A meaningful difference was confirmed in both of the groups on the comparison of hypopharyngeal and distal oesphageal measurements ( p 0,05). Acid clearance time was shorter in proximal oesophagus (in average 1.41 minutes in group 1 and 1.81 minutes in group 2) compared to the distal oesophagus (meanly 1.85 minutes in group 1 and 2.62 minutes in group 2). No difference was found in comparison of group 1 and 2 on the basis of all measurements (p>0,05). The observed 55 cough attacks of the 59 patients (93 %) in group 1 were related to oesophagel reflux. Twenty-four vomiting and regurgitation complaints of the 29 patients (83%) observed in group 2 were related to the reflux. Conclusion: Patients with respiratory complaints or gastrointestinal symptoms don’t have significantly different proximal oesophageal function in oesophageal acid clearance or total reflux time. The cause of respiratory symptoms seems to be multifactorial and comorbid factors should be corrected in children with hypopharyngeal reflux.