Children with Cystic Fibrosis Have Prolonged Chemical Clearance of Acid Reflux Compared to Symptomatic Children Without Cystic Fibrosis

dc.contributor.authorWoodley, Frederick W.
dc.contributor.authorMachado, Rodrigo S. [UNIFESP]
dc.contributor.authorHayes, Don
dc.contributor.authorDi Lorenzo, Carlo
dc.contributor.authorKaul, Ajay
dc.contributor.authorSkaggs, Beth
dc.contributor.authorMcCoy, Karen
dc.contributor.authorPatel, Alpa
dc.contributor.authorMousa, Hayat
dc.contributor.institutionNationwide Childrens Hosp
dc.contributor.institutionOhio State Univ
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionCincinnati Childrens Hosp Med Ctr
dc.contributor.institutionUniv Cincinnati
dc.description.abstractObjectives Few studies compare gastroesophageal reflux (GER) parameters of cystic fibrosis (CF) children and symptomatic non-CF children. We aimed to compare the impedance-pH (IMP-pH) parameters for these two groups and to test the hypothesis that prolonged acid exposure in CF patients is due to delayed chemical clearance (CC).IMP-pH tracings from 16 CF children (median 8.2 years) and 16 symptomatic non-CF children (median 8.3 years) were analyzed. Software was used to generate IMP-pH reports and parameter data were extracted. IMP-pH was used to calculate the mean CC for each patient.pH studies showed no difference in acid GER (AGER) frequency (p = 0.587); however, mean AGER duration, duration of longest AGER, AGER index, and DeMeester scores were all significantly higher for CF patients. IMP showed no difference in GER frequency [neither acidic (p = 0.918) nor non-acidic (p = 0.277)], but total bolus clearance was more efficient in CF patients (p = 0.049). A larger percentage of total GER reached the proximal esophagus in non-CF children (p = 0.039). Analyses of two-phase AGER episodes showed that these events were more acidic (p = 0.003) and the CC phase was significantly prolonged in the CF cohort (p = 0.001).Compared to symptomatic non-CF children, CF children do not have more frequent reflux. Actually, they have better bolus clearance efficiency following reflux and may even have better control over the number of GER episodes that reach the proximal esophagus. CC of AGER, however, is significantly prolonged in the CF cohort, likely due to hyperacidity of refluxed gastric contents.en
dc.description.affiliationNationwide Childrens Hosp, Div Gastroenterol Hepatol & Nutr, Columbus, OH 43205 USA
dc.description.affiliationOhio State Univ, Coll Med, Dept Pediat, Columbus, OH 43205 USA
dc.description.affiliationUniversidade Federal de São Paulo, São Paulo, Brazil
dc.description.affiliationNationwide Childrens Hosp, Columbus, OH USA
dc.description.affiliationCincinnati Childrens Hosp Med Ctr, Div Gastroenterol Hepatol & Nutr, Cincinnati, OH 45229 USA
dc.description.affiliationUniv Cincinnati, Coll Med, Dept Pediat, Cincinnati, OH USA
dc.description.affiliationUnifespUniversidade Federal de São Paulo, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.identifier.citationDigestive Diseases and Sciences. Dordrecht: Springer, v. 59, n. 3, p. 623-630, 2014.
dc.relation.ispartofDigestive Diseases and Sciences
dc.rightsAcesso restrito
dc.subjectCystic fibrosisen
dc.subjectAcid refluxen
dc.subjectChemical clearanceen
dc.subjectVolume clearanceen
dc.subjectProximal extenten
dc.titleChildren with Cystic Fibrosis Have Prolonged Chemical Clearance of Acid Reflux Compared to Symptomatic Children Without Cystic Fibrosisen