Evaluation of Laryngopharyngeal Reflux in Pediatric Patients with Asthma Using Pharyngeal pH-Monitoring: The Impact of a New Technique

Banaszkiewicz A, Dembinski L, Zawadzka-Krajewska A, et al. Adv Exp Med Biol. 2013;755:89-95.

OBJECTIVES: There is constant discussion about the association between asthma and gastroesophageal and/or laryngopharyngeal reflux. Pharyngeal pH-monitoring is a new technique that allows a physician to check whether reflux really crosses the upper oesophageal sphincter barrier. The aim of the study was to assess the prevalence of laryngopharyngeal reflux (LPR) in children with difficult-to-treat asthma.

RESULTS: A total of 21 subjects (mean age of 12.74 years old) were enrolled in the study. Laryngopharyngeal reflux was diagnosed in 13 (61.9%) children. The prevalence of LPR was between 56% and 68%. No association was found between the diagnosis of reflux and anthropometric data, spirometry results, age of asthma diagnosis and total IgE level. There was a positive correlation between LPR diagnosis and the degree of asthma control (77% vs. 12.5% at the 4th step of asthma treatment, p=0.0121). LPR was more frequent in higher fluticasone dose users as compared with lower dose users (p=0.01977, OR=17.27) and in montelukast users as compared with nonusers (p=0.0075, OR=19). The mean Reflux Symptoms Index score was almost two times higher in patients with reflux as compared with those without reflux (13.2 vs. 6.75, respectively, p=0.00337).

CONCLUSION: The prevalence of laryngopharyngeal reflux in children with difficult-to-treat asthma is high (between 56% and 68%).

 

Topics: pH monitoring, Pulmonology, pediatric reflux, 2013

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