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Influence of Feeding and State of Alertness on the Incidence of Gastroesophageal Reflux in Children

Journal of the Korean Pediatric Society 1997;40(10):1419-1426.
Published online October 15, 1997.
Influence of Feeding and State of Alertness on the Incidence of Gastroesophageal Reflux in Children
Kyung Mo Kim, Jung Yeon Shim, Soo Jong Hong
Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
소아에서 수면 및 식사에 따른 위식도역류의 발생에 관한 연구
김경모, 심정연, 홍수종
울산의대 서울중앙병원 소아과
Abstract
Purpose
: The aim of this study is to evaluate the influence of the feeding (fastingpostprandial) and the state of alertness(awake-asleep) on the amount of gastroesophageal reflux by using 24hour esophageal pH metry.
Methods
: From July 1994 to June 1995, 32 cases of 24 hour esophageal pH metry had been done at the Asan Medical Center. Twenty three children with normal pH monitoring and 9 children with abnormal pH monitoring were included in this study. The children ranged in age from 13 days to 8 years old. Indications of the study were vomiting in 6, chronic respiratory symptoms in 22, chest pain in 2 and abdominal pain in 2 children. The parameters studied in this study were reflux index, the number of reflux episodes, the duration of the longest reflux episodes and the number of the reflux episodes lasting over 5 minutes. The former 4 parameters were analyzed according to feeding and the state of alertness between normal group and patient group respectively.
Results
: 1) All four parameters were different between normal and patient group except No. of reflux episode longer than 5minutes per hour. 2) With regard to feeding in n normal group, reflux index and number of reflux episodes during fasting period were significantly higher than postprandial period. But duration of longest reflux episode and number of episodes lasting longer than 5 minutes were not. 3) With regard to alertness in normal group, reflux index and number of reflux episodes during alert period were significantly higher. Duration of longest reflux episode and number of episodes lasting longer than 5minutes were lower but was not statistically significant. 4) With regard to feeding in patient group, reflux index and number of reflux episodes during fasting period were significantly higher than postprandial period. But duration of longest reflux episode and number of episodes lasting longer than 5 minutes were not. 5) With regard to alertness in patient group, number of reflux episodes during awake period was significantly higher, but reflux index was not. Duration of longest reflux episode and number of episodes lasting longer than 5minutes were lower but was not statistically significant.
Conclusions
: The reflux index was significantly higher during postprandial and alert period both in normal and patient group except that in patient group between sleep and alert period. It is suggested that the esophageal clearance of children in our country is excellent than other country.
Key Words: Gastroesophageal reflux, Esophageal pH monitoring, Feeding, Alertness, Sleep, Awake


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