Childhood GERD associated with several respiratory disorders

NEW YORK (Reuters Health) – In children without neurological defects, gastroesophageal reflux disease (GERD) is associated with an increased risk of sinusitis, laryngitis, asthma, pneumonia, and bronchiectasis, according to a report in the December issue of Gastroenterology.

In a large case-control study, Dr. Hashem B. El-Serag, of the Houston Veterans Affairs Medical Center, Texas, and colleagues compared 1980 children with GERD with 7920 control subjects. "Cases and controls were without neurological defects or congenital esophageal anomalies," the researchers explain.

Children with GERD were older than controls (9.16 vs. 8.64 years, p < 0.0001). In addition, cases were more likely to be female (51% versus 47%; p = 0.0028) and white (60% versus 41%; p < 0.0001).

In univariate analysis, children with GERD had more sinusitis (4.19% versus 1.35%) and laryngitis (0.71% versus 0.19%) than controls. In addition, they had more asthma (13.18% versus 6.76%), pneumonia (6.26% versus 2.27%), and bronchiectasis (0.96% versus 0.06; all p < 0.0001). The team notes that cases had less otitis media than controls (2.07% versus 4.62%; p < 0.0001).

"After adjusting for differences in ages, gender, and ethnicity in the regression analysis, GERD remained a significant risk factor for sinusitis (adjusted odds ratio [OR], 2.3; p <0.0001), laryngitis (OR, 2.6; p = 0.0228), asthma (OR, 1.9; p < 0.0001), pneumonia (OR 2.3; p < 0.0001), and bronchiectasis (OR, 2.3; p = 0.0193)," Dr. El-Serag and colleagues report.

They say, however, that they cannot tell if there is a cause-effect relationship between GERD and these extraesophageal disorders.

Gastroenterology 2001;121:1294-1299.

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