Clinical predictors of pathological gastro-oesophageal reflux in infants with persistent distress

Journal of Paediatrics and Child Health
Ralf G HeineA G Catto-Smith

Abstract

Gastro-oesophageal reflux (GOR) is common in infants with persistent crying. Empirical treatment with antireflux medications is common practice, although on clinical grounds it may be difficult to determine whether GOR is abnormal. To examine the diagnostic accuracy of clinical predictors of pathological GOR in infants with persistent crying. One hundred and fifty-one infants (82 male; median age 2.5 months, range 0.5-8.2 months) with persistent crying were prospectively studied. Crying and fussing were charted for 24 h, and parents completed a validated questionnaire on reflux symptoms. All infants underwent oesophageal 24-h pH monitoring. Twenty-seven (17.9%) infants had pathological GOR with a fractional reflux time (FRT) >10%. There was no significant association between total crying duration per 24 and FRT (P = 0.84) or the number of reflux episodes (P = 0.68). Pathological GOR was more common in infants under 3 months, compared to older infants (P = 0.04). Feeding difficulties were significantly associated with pathological GOR (P = 0.02). Backarching was not increased in infants with GOR (P = 0.30). Pathological GOR was significantly associated with the frequency of regurgitation (P = 0.04), but not with vomitus volume (...Continue Reading

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Citations

Oct 19, 2006·Journal of Paediatrics and Child Health·Phillip Kolos
Dec 17, 2009·Pediatrics·Catherine A GolskiAnna Maria Hibbs
Sep 29, 2015·Expert Review of Gastroenterology & Hepatology·Yvan Vandenplas, Bruno Hauser
Oct 24, 2007·Emergency Medicine Clinics of North America·Martin Herman, Audrey Le
Dec 21, 2012·Journal of Paediatrics and Child Health·David Forbes
Jun 28, 2012·Journal for Specialists in Pediatric Nursing : JSPN·Madalynn NeuCassandra Marcheggiani-Howard
Apr 26, 2012·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Gabrielle ZimbricRajendu Srivastava
Aug 4, 2016·Nature Reviews. Gastroenterology & Hepatology·Kornilia NikakiDaniel Sifrim
Apr 9, 2009·The American Journal of Gastroenterology·Philip M ShermanYvan Vandenplas
Sep 4, 2018·Clinical Pediatrics·Nusa Matijasic, Zdenka Plesa Premilovac
May 4, 2006·Current Opinion in Allergy and Clinical Immunology·Ralf G Heine
Oct 6, 2011·Journal of Pediatric Gastroenterology and Nutrition·Carlos Lifschitz
Jan 18, 2013·Journal of Pediatric Gastroenterology and Nutrition·Rachel J van der PolMichiel P van Wijk
Jan 28, 2014·Journal of Pediatric Gastroenterology and Nutrition·Pauline De BruyneMyriam Van Winckel
Apr 26, 2019·Global Pediatric Health·Desiree Rivera-NievesDevendra Mehta
May 16, 2018·Nature Reviews. Gastroenterology & Hepatology·Judith ZeevenhoovenMarc A Benninga
Nov 6, 2020·European Journal of Pediatrics·Elvira Ingrid LevyJ Peter de Winter

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