Systematic review: the extra-oesophageal symptoms of gastro-oesophageal reflux disease in children
Article first published online: 29 OCT 2008
© 2009 The Authors. Journal compilation © 2009 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 29, Issue 3, pages 258–272, February 2009
How to Cite
TOLIA, V. and VANDENPLAS, Y. (2009), Systematic review: the extra-oesophageal symptoms of gastro-oesophageal reflux disease in children. Alimentary Pharmacology & Therapeutics, 29: 258–272. doi: 10.1111/j.1365-2036.2008.03879.x
- Issue published online: 22 DEC 2008
- Article first published online: 29 OCT 2008
- Publication data Submitted 2 October 2008 First decision 16 October 2008 Resubmitted 21 October 2008 Accepted 25 October 2008 Epub Accepted Article 29 October 2008
Background Extra-oesophageal symptoms are thought to be common, atypical symptoms of gastro-oesophageal reflux disease (GERD) in children.
Aim To investigate the prevalence of GERD in children with extra-oesophageal symptoms or of extra-oesophageal symptoms in children with GERD, and the effect of GERD therapies on extra-oesophageal symptoms.
Methods A systematic review of articles in PubMed and EMBASE.
Results We identified 18 relevant articles. The pooled weighted average prevalence of GERD in asthmatic children was 23%, compared with 4% in healthy controls from the same five studies. The majority of studies evaluating the relationship between apparent life-threatening event (ALTE) and GERD did not suggest a causal relationship. Seven studies reported that respiratory symptoms, sinusitis and dental erosion were significantly more prevalent in children with GERD than in controls. Data from pharmacotherapeutic trials were inconclusive and provided no support for a causal relationship between GERD and extra-oesophageal symptoms.
Conclusions Possible associations exist between GERD and asthma, pneumonia, bronchiectasis, ALTE, laryngotracheitis, sinusitis and dental erosion, but causality or temporal association were not established. Moreover, the paucity of studies, small sample sizes and varying disease definitions did not allow firm conclusions to be drawn. Most trials of GERD therapies showed no improvement in extra-oesophageal symptoms in children.