Role of proximal gastric acid reflux in causation of respiratory symptoms in children with gastroesophageal reflux.

OBJECTIVES The association of gastroesophageal reflux (GER) and respiratory disorders is well known but the mechanism is still unclear. This study aims to evaluate the presence and severity of proximal gastric acid reflux in children having GER with or without respiratory symptoms. METHODS 24 hour esophageal pH monitoring with a dual pH probe placed in the proximal and distal esophagus was performed in 23 and 31 children having GER with or without respiratory symptoms, respectively. RESULTS No significant difference in the parameters of pH monitoring in either proximal or distal esophagus was observed between GER patients with or without respiratory symptoms. The proportion of patients having proximal GER among those with respiratory symptoms was not significantly different from those without respiratory symptoms (P > 0.05). CONCLUSION Proximal esophageal acid reflux does not seem to play a role in the development of persistent respiratory symptoms in children with GER. Distal esophageal acid reflux is the predominant form of reflux in children with GER regardless of the occurrence of respiratory symptoms.