Semeniuk J, Kaczmarski M
III Department of Pediatrics, Medical University of Białystok, ul. Waszyngtona 17, 15-274 Białystok, Poland.
Adv Med Sci. 2006;51:327-35.
Gastroesophageal reflux (acid GER), primary and secondary, has a wide spectrum of clinical symptoms and occurs at developmental age. The study objective was to elaborate the clinical profile of symptoms and to determine whether there are any differences in clinical manifestations between the two acid GER conditions, i.e. primary and secondary to cow milk allergy and/or other food allergy (CMA/FA).
The study involved 264 children of both genders and at various age, with diverse reflux symptoms from one or many organs and with a positive family history of alimentary tract diseases. Based on preliminary diagnostic tests, the children were divided into groups. In 138 children, pathological acid GER, primary and secondary to CMA/FA, was recognized.
The profile of clinical symptoms observed in 264 children with suspected gastroesophageal reflux disease (GERD) was elaborated according to their frequency. Among differentiating symptoms the most common were: vomiting (12.1%), bronchitis (10.9%) and pneumonia (9.6%). In the group of 138 GER children, 32 (23.2%) had monosystemic symptoms, in the other 106 patients (76.8%) many systems were affected. The most frequent reflux symptoms were: in primary GER (group 2)--alimentary tract disorders (28.6%), pneumonia and bronchitis (20.7%) and neurological symptoms with torticollis (7.4%); in secondary GER (group 3)--alimentary tract disorders: vomiting and anxiety/crying (25.2%); pneumonia and bronchitis (19.4%). In 23 children (37%) with secondary GER, typical allergic symptoms were found to coexist. The 138 GER patients underwent allergologic and immunologic tests to confirm the allergic background of symptoms.
Clinical symptoms caused by the presence of secondary acid GER are non-specific, being identical or similar to those observed in primary acid GER. Allergologic and immunologic tests are useful to confirm or exclude the relationship between GER and CMA/FA in the study children.
原发性和继发性胃食管反流（酸性胃食管反流）具有广泛的临床症状，且在发育年龄段出现。本研究的目的是阐述症状的临床特征，并确定原发性和继发性酸性胃食管反流（即继发于牛奶过敏和/或其他食物过敏（CMA/FA））在临床表现上是否存在差异。
本研究纳入了264名不同性别的各年龄段儿童，他们有来自一个或多个器官的各种反流症状，且有消化道疾病家族史阳性。根据初步诊断测试，将儿童分组。在138名儿童中，确诊为原发性和继发于CMA/FA的病理性酸性胃食管反流。
根据264名疑似胃食管反流病（GERD）儿童的临床症状出现频率，阐述了其临床症状特征。在鉴别症状中，最常见的是：呕吐（12.1%）、支气管炎（10.9%）和肺炎（9.6%）。在138名胃食管反流儿童组中，32名（23.2%）有单系统症状，另外106名患者（76.8%）多个系统受累。最常见的反流症状为：原发性胃食管反流（第2组）——消化道疾病（28.6%）、肺炎和支气管炎（20.7%）以及伴有斜颈的神经症状（7.4%）；继发性胃食管反流（第3组）——消化道疾病：呕吐和焦虑/哭闹（25.2%）；肺炎和支气管炎（19.4%）。在23名（37%）继发性胃食管反流儿童中，发现同时存在典型的过敏症状。对138名胃食管反流患者进行了过敏和免疫测试，以确认症状的过敏背景。
继发性酸性胃食管反流引起的临床症状是非特异性的，与原发性酸性胃食管反流中观察到的症状相同或相似。过敏和免疫测试有助于确认或排除研究儿童中胃食管反流与CMA/FA之间的关系。
