[The association between gastroesophageal reflux and recurrent lower respiratory tract infections and bronchial asthma in children].

INTRODUCTION: It is well known that gastroesophageal reflux (GER) coincides with chronic diseases of the lower respiratory tract. However, the impact of effective management of gastroesophageal reflux on the course of coexisting pathologies of the lower respiratory tract has not been unequivocally evaluated. This study was undertaken to assess the impact of treatment of gastroesophageal reflux on the course of recurrent lower respiratory tract infections and bronchial asthma in children.

MATERIAL AND METHODS: We enrolled 76 children, 38 boys and 38 girls, aged 1-204 months (median: 66.5 months). All children had clinical symptoms of gastroesophageal reflux. The children were allocated to three groups: Group I: recurrent lower respiratory tract infections (33 children); Group II: bronchial asthma (23 children); Group III: no chronic respiratory tract disease (20 children). Groups were similar with respect to age and gender. Upper gastrointestinal tract scintigraphy and endoscopy were performed in all children. The children were followed for 1-23 months (mean: 7 months). In most cases, GER was managed conservatively, except for four children who were operated.

RESULTS: Complete or partial resolution of GER symptoms was seen in 89% of patients, no change was noted in 9%, and progression was seen in the remaining 2% of children. Treatment of GER was accompanied by alleviation of respiratory symptoms in 84% of children (group I and II).

CONCLUSIONS: Effective therapy of gastroesophageal reflux decreases the frequency of recurrent lower respiratory tract infections and improves asthma control.