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Tytuł: Gastroesophageal reflux in children with cystic fibrosis is more frequent in postprandial time

Jaroslaw Walkowiak, Beata Oralewska, Danuta Celińska-Cedro, Tomasz Songin, Bartosz Bychowiec, Mikolaj Teisseyre, Marian Krawczyński, Jerzy Socha
Pediatria Współczesna Gastroenterologia, Hepatologia i Żywienie Dziecka
Strona początkowa:
Strona końcowa:
Słowa kluczowe:
gastroesophageal reflux, cystic fibrosis, postprandial time

Introduction: There are few data regarding the influence of normal life activity on the presence of gastroesophageal reflux disease (GERD) in cystic fibrosis (CF). In the present study, the influence of body position and postprandial time on the incidence of GERD has been assessed. Material and methods: Ninety CF patients aged from 2 to 18 years were introduced into the study. In all children, esophageal 24-hour pH monitoring was performed. Results: GERD was detected in 54 patients (60%). In most patients, however, GERD was asymptomatic. The total number of reflux episodes per hour in the supine position was significantly lower than in the remaining time (p<0.0001). Having excluded the 2h-postprandial time, the difference was still statistically significant (p<0.002). The total number of reflux episodes per hour in 1h- and 2h-postprandial time was significantly higher than in the upright position excluding the respective postprandial time (p<0.0001). No statistically significant difference in the number of episodes lasting longer than five minutes per hour in the supine and in the upright position was stated. There were more episodes lasting longer than five minutes per hour in the postprandial time than in the upright position in the remaining time (1h- and 2h-postprandial time excluded – p<0.004 and p<0.002, respectively). RI was higher in the upright than in supine position (p<0.0001). However, after the exclusion of 2h-postprandial time, no significant differences in RI were found. In conclusion, a high frequency of GERD in CF patients regardless of the presence/absence of typical clinical manifestation was documented. Reflux index was higher in postprandial time. In the supine position, there was a tendency towards less frequent and longer lasting reflux episodes.