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Symptoms of gastroesophageal reflux disease in children
Last reviewed: 23.04.2024
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In the structure of clinical symptoms of gastroesophageal reflux disease in children, esophageal and extra-oesophageal symptoms are distinguished.
Esophageal symptoms include heartburn, regurgitation, a symptom of a "wet spot on the pillow," belching (air, sour, bitter), periodic chest pain, pain or discomfort when passing through the esophagus (lonely phlegm), dysphagia. The degree of severity of these symptoms in children is due mainly to the state of the lower esophageal sphincter motility, and not to the morphological state of the mucosa of the esophagus.
Esophageal symptoms are mainly associated with the involvement of bronchopulmonary, cardiovascular and ENT organs. According to different authors, the incidence of gastroesophageal reflux in children with bronchial asthma ranges from 55 to 80%. There is information about the connection of the development of gastroesophageal reflux with chronic pneumonia, relapsing and chronic bronchitis, cystic fibrosis. Associated with gastroesophageal reflux, bronchial obstruction can be suspected in children when coughing or choking occurs mostly at night, after a heavy meal. It should also take into account the complex of respiratory and esophageal symptoms, the presence of a positive effect of trial antireflux therapy, prolonged course and non-atopic nature of bronchial asthma, despite adequate treatment.
Otorhinolaryngological symptoms include constant cough, a feeling of perspiration in the throat, hoarseness of the voice, pain in the ear, frequent otitis.
A relationship of gastroesophageal reflux with tooth enamel erosions and caries development has been established. Associated with gastroesophageal reflux cardiovascular symptoms - arrhythmias due to initiation of an esophagocardial reflex, pain in the heart.
At an early age, the gastroesophageal reflux disease manifests with regurgitation in combination with a decrease in body weight, vomiting is possible with a "fountain", with an admixture of blood or bile, and there are respiratory disorders up to apnea and sudden death syndrome. With hiatal hernia, unusual head and neck movements associated with episodes of reflux (Sandyfer's syndrome) are possible.
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