GASTROESOPHAGEAL
REFLUX AND APPLE JUICE CHALLENGE IN ASTHMATIC CHILDREN
Kudlicka
A, Chrzastek-Spruch H, Emeryk A, Wallner G
Department
of Paediatrics, Medical University School of Lublin, Poland
Objective:
The aim of the study was to evaluate the coexistance of gastroesophageal
reflux (GER) and airways obstruction after acidification esophagus in
asthmatic children. We investigated 52 subjects aged 5-14 years with
moderate or severe bronchial asthma and clinical symptoms which may be
associated with GER.
Methods:
24-hour esophageal ph-monitoring and apple juice challenge (AJC) to detect
bronchial hyperreactivity induced from esophagus in all children were
performed. We accepted the criteria of positive AJC acc. to Santucci et
al., e.g. significant fall of bronchial airflow indices: FEV1, FVC, MEF25
after acidification of esophagus with pH=3,5 apple juice.
Results:
Pathological GER showed 34 children. Positive AJC was detected in 27
patients. Comparison of 24-hour esophageal monitoring and AJC results indicated
74% compatibility. In group of 34 children with pathological GER there were
found 24 cases with positive AJC and 10 cases with negative AJC. There was
statistically significant difference between these subgroups of patients
(P<0,02).
Conclusions:
1/ In asthmatic children GER is often observed, but not always
acidification of esophagus leads to bronchial hyperactivity. 2/ Positive
AJC in asthmatic children suggests diagnosis of GER and can be used as a
screening test.