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Can the Reflux Finding Score and Reflux Symptom Index Be Used to Evaluate the Severity of Esophagitis in Children?
J Voice 2019JV

Abstract

OBJECTIVES

Laryngopharyngeal reflux (LPR), a growing issue in ear, nose, and throat (ENT) and pediatric medicine, is the backflow of stomach contents into the laryngopharynx. Patients present with frequent upper and/or lower respiratory tract infections and coughs, associated with acid- and pepsin-mediated injury to the mucosae of the larynx and pharynx. LPR is associated with rhinosinusitis, laryngitis, pneumonia, and asthma. Children with LPR often fail to exhibit classic gastroesophageal reflux disease symptoms, or such symptoms may be intermittent. Only a few studies have sought correlations among symptoms, endoscopic findings, and the results of frequently used diagnostic tests.

THE AIM OF OUR STUDY

We sought associations among the Reflux Finding Score (RFS), Reflux Symptom Index (RSI), and the pathological extent of esophagitis.

METHODS

We reviewed data on children who underwent upper gastrointestinal tract endoscopy and showed LPR symptoms, as reported by the ENT department. The RSI was scored by pediatric gastroenterologists and the RFS by ENT doctors, via laryngoscopic examination. The pathological esophageal data were evaluated retrospectively.

RESULTS

We treated 52 patients (29 boys) with a mean age of 11.4 ± 4.5 years. On pathological evaluation, one patient exhibited normal esophageal findings, while 28 showed mild esophagitis, 16 esophagitis, and 8 severe esophagitis. Thirteen patients showed esophageal pseudopolypoid lesions secondary to gastroesophageal reflux disease on endoscopic examination, but were human papilloma virus-negative. There was no correlation among the RFS, RSI score, and age, but there was a significant correlation between the pathological data and the RFS (P = 0.010; r = 0.461).

CONCLUSIONS

The incidence of LPR/esophagitis in children may differ from that in adults. Therefore, ENT specialists should determine esophagitis status in children and, if necessary, consult pediatric gastroenterologists.

Authors+Show Affiliations

Yeditepe University Medical Faculty, Pediatrics, Gastroenterology Hepatology and Nutrition Department, Istanbul, Turkey.Yeditepe University Medical Faculty, Ear Nose & Throat Department, Istanbul, Turkey. Electronic address: muzo657@yahoo.com.Yeditepe University Medical Faculty, Ear Nose & Throat Department, Istanbul, Turkey.Yeditepe University Medical Faculty, Pathology Department, Istanbul, Turkey.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31447186

Citation

Ugras, Meltem Korkut, et al. "Can the Reflux Finding Score and Reflux Symptom Index Be Used to Evaluate the Severity of Esophagitis in Children?" Journal of Voice : Official Journal of the Voice Foundation, 2019.
Ugras MK, Dogan M, Pata DYS, et al. Can the Reflux Finding Score and Reflux Symptom Index Be Used to Evaluate the Severity of Esophagitis in Children? J Voice. 2019.
Ugras, M. K., Dogan, M., Pata, D. Y. S., & Ozkan, F. (2019). Can the Reflux Finding Score and Reflux Symptom Index Be Used to Evaluate the Severity of Esophagitis in Children? Journal of Voice : Official Journal of the Voice Foundation, doi:10.1016/j.jvoice.2019.07.023.
Ugras MK, et al. Can the Reflux Finding Score and Reflux Symptom Index Be Used to Evaluate the Severity of Esophagitis in Children. J Voice. 2019 Aug 23; PubMed PMID: 31447186.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Can the Reflux Finding Score and Reflux Symptom Index Be Used to Evaluate the Severity of Esophagitis in Children? AU - Ugras,Meltem Korkut, AU - Dogan,Muzeyyen, AU - Pata,D Yavuz Selim, AU - Ozkan,Ferda, Y1 - 2019/08/23/ PY - 2019/07/08/received PY - 2019/07/25/revised PY - 2019/07/26/accepted PY - 2019/8/27/entrez KW - Esophagitis KW - Laryngopharyngeal reflux KW - Reflux Finding Score KW - Reflux Symptom Index JF - Journal of voice : official journal of the Voice Foundation JO - J Voice N2 - OBJECTIVES: Laryngopharyngeal reflux (LPR), a growing issue in ear, nose, and throat (ENT) and pediatric medicine, is the backflow of stomach contents into the laryngopharynx. Patients present with frequent upper and/or lower respiratory tract infections and coughs, associated with acid- and pepsin-mediated injury to the mucosae of the larynx and pharynx. LPR is associated with rhinosinusitis, laryngitis, pneumonia, and asthma. Children with LPR often fail to exhibit classic gastroesophageal reflux disease symptoms, or such symptoms may be intermittent. Only a few studies have sought correlations among symptoms, endoscopic findings, and the results of frequently used diagnostic tests. THE AIM OF OUR STUDY: We sought associations among the Reflux Finding Score (RFS), Reflux Symptom Index (RSI), and the pathological extent of esophagitis. METHODS: We reviewed data on children who underwent upper gastrointestinal tract endoscopy and showed LPR symptoms, as reported by the ENT department. The RSI was scored by pediatric gastroenterologists and the RFS by ENT doctors, via laryngoscopic examination. The pathological esophageal data were evaluated retrospectively. RESULTS: We treated 52 patients (29 boys) with a mean age of 11.4 ± 4.5 years. On pathological evaluation, one patient exhibited normal esophageal findings, while 28 showed mild esophagitis, 16 esophagitis, and 8 severe esophagitis. Thirteen patients showed esophageal pseudopolypoid lesions secondary to gastroesophageal reflux disease on endoscopic examination, but were human papilloma virus-negative. There was no correlation among the RFS, RSI score, and age, but there was a significant correlation between the pathological data and the RFS (P = 0.010; r = 0.461). CONCLUSIONS: The incidence of LPR/esophagitis in children may differ from that in adults. Therefore, ENT specialists should determine esophagitis status in children and, if necessary, consult pediatric gastroenterologists. SN - 1873-4588 UR - https://www.unboundmedicine.com/medline/citation/31447186/Can_the_Reflux_Finding_Score_and_Reflux_Symptom_Index_Be_Used_to_Evaluate_the_Severity_of_Esophagitis_in_Children L2 - https://linkinghub.elsevier.com/retrieve/pii/S0892-1997(19)30309-1 DB - PRIME DP - Unbound Medicine ER -