| Clinical predictors of pathological gastro-oesophageal reflux in infants with persistent distress. | |
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MedLine Citation:
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PMID: 16509914 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Gastro-oesophageal reflux (GOR) is common in infants with persistent crying. Empirical treatment with antireflux medications is common practice, although on clinical grounds it may be difficult to determine whether GOR is abnormal. AIMS: To examine the diagnostic accuracy of clinical predictors of pathological GOR in infants with persistent crying. METHODS: One hundred and fifty-one infants (82 male; median age 2.5 months, range 0.5-8.2 months) with persistent crying were prospectively studied. Crying and fussing were charted for 24 h, and parents completed a validated questionnaire on reflux symptoms. All infants underwent oesophageal 24-h pH monitoring. RESULTS: Twenty-seven (17.9%) infants had pathological GOR with a fractional reflux time (FRT) >10%. There was no significant association between total crying duration per 24 and FRT (P = 0.84) or the number of reflux episodes (P = 0.68). Pathological GOR was more common in infants under 3 months, compared to older infants (P = 0.04). Feeding difficulties were significantly associated with pathological GOR (P = 0.02). Backarching was not increased in infants with GOR (P = 0.30). Pathological GOR was significantly associated with the frequency of regurgitation (P = 0.04), but not with vomitus volume (P = 0.62). Regurgitation more than 5 times daily was the most specific reflux symptom (specificity 70.9%), but was a poor predictor of pathological GOR (positive predictive value 22.2%). In the absence of frequent regurgitation or feeding difficulties, pathological GOR was unlikely (negative predictive value 87-90%). CONCLUSIONS: Investigation and treatment of GOR in infants with persistent crying should be primarily directed at infants presenting with frequent regurgitation or feeding difficulties. |
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Authors:
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Ralf G Heine; Brigid Jordan; Lionel Lubitz; Michele Meehan; Anthony G Catto-Smith |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of paediatrics and child health Volume: 42 ISSN: 1034-4810 ISO Abbreviation: J Paediatr Child Health Publication Date: 2006 Mar |
Date Detail:
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Created Date: 2006-03-02 Completed Date: 2007-02-16 Revised Date: 2007-09-24 |
Medline Journal Info:
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Nlm Unique ID: 9005421 Medline TA: J Paediatr Child Health Country: Australia |
Other Details:
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Languages: eng Pagination: 134-9 Citation Subset: IM |
Affiliation:
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Department of Gastroenterology and Clinical Nutrition, Royal Children's Hospital, Melbourne, Australia. ralf.heine@rch.org.au |
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| MeSH Terms | |
Descriptor/Qualifier:
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Age Factors Analysis of Variance Australia Breast Feeding Chronic Disease Colic* / complications Crying* / physiology Esophageal pH Monitoring Female Gastroesophageal Reflux / diagnosis*, physiopathology Hospitals, Pediatric Humans Infant Infant Formula Male Medical Records Prognosis Questionnaires Sex Factors Time Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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