Esophagitis and findings of long-term esophageal pH recording in children with repeated lower respiratory tract symptoms.

Esophagoscopy was performed on 116 children with recurrent lower respiratory tract symptoms; esophagitis of various degrees was detected in 45% of the cases. The presence of verified esophagitis correlated with endoscopic findings of bile-stained gastric contents, suggesting a role of bile reflux in the pathogenesis. Esophageal pH recordings covering an 18-24-h period were performed on 22 patients with esophagitis and 19 patients without esophagitis. Gastroesophageal reflux (GER) during the sleeping period was detected in 95% of children with esophagitis, as compared to 42% in children with no esophagitis (p less than 0.001). The percentage of time with esophageal pH below 4 of the total registration time was significantly greater (p less than 0.05) in children with esophagitis (9.5%) than in those with no esophagitis (4.0%)--the difference being due to a greater share of nocturnal GER of the recording time. These criteria could be applied to a search for clinically significant GER in children with recurrent lower respiratory tract symptoms and to select patients for esophagoscopy.