Gastroesophageal reflux in infants with lower respiratory tract infection

Objectives To investigate the relationship between gastroesophageal reflux (GER) and lower respiratory tract infection in infants. Methods The 24-hours distal esophageal pH study was done by using the Synectics Digitrapper MK Ⅲ portable pH-recording device. Eighty-nine cases (average age 10.5 ± 0.9 months) with lower respiratory tract in fection were enrolled in the study according to the one of the three criteria as follows:(1)Had the lower respiratory tract infection more than once during the last three months. (2)The symptoms of cough and wheezing lasted for longer than half of one month even after therapy. (3)With the history of vomiting. Asymptomatic 26 infants (average age 13.7 ± 2.1 months) were served as controls. Results (1)All the parameters of acid reflux were significantly higher in patients than those in the controls (P 0.001). The ratio of pathological GER in patient group was 79.8 % (71/89),significantly higher than that of the controls. (2)The episode of acid reflux,the number of episodes of acid reflux lasting 5 min or longer,the longest reflux time,the total percent time of pH 4 and Boix-Ochoa score in infants were significantly higher than that of the children more than 1 year of age (P 0.01 or 0.05). (3)The GER in twenty-nine of the seventy-one patients with lower respiratory tract infection were found to have higher body weight ( eightieth percentile). While half of the infants with GER had the higher body weight,the difference was significant in comparison with the patients older than 1-year-old. Conclusions GER is very common in infants. Vomiting and lower body weight are major indicative clues. GER is related to lower respiratory tract infection,refractory respiratory disease and episode of asthma in some cases.