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a Royal Children's
Hospital, Melbourne, Australia: Department of
Gastroenterology, b Department of Physiotherapy, c Department of Thoracic Medicine
Correspondence to: Dr A G Catto-Smith, Department of Gastroenterology, Royal Children's Hospital, Flemington Road, Parkville, Victoria 3052, Australia. e-mail: cattosmt{at}cryptic.rch.unimelb.edu.au
Accepted 22 August 1997
AIM
To establish the incidence of pathological
gastro-oesophageal reflux (GOR) in newly diagnosed infants with cystic
fibrosis and to identify clinical predictors of increased reflux.
METHODS
26 infants with cystic fibrosis less than
6 months of age (14 male, 12 female; mean (SEM) age 2.1 (0.21) months,
range 0.8 to 5.6 months) underwent prolonged oesophageal pH monitoring
(mean duration 27.1 (0.49) hours; range 21.3 to 30.2 hours). Reflux symptoms, anthropometric variables, pancreatic status, meconium ileus,
genotype, and chest x ray findings were correlated with pH
monitoring data.
RESULTS
Five infants (19.2%) had an abnormal
fractional reflux time of greater than 10%, seven (26.9%) of 5-10%,
and 14 (53.8%) of below 5%. Infants who presented with frequent
vomiting had a significantly higher fractional reflux time than infants
who had infrequent or no vomiting. There was no significant association
between abnormal chest x rays and pathological GOR. Sex,
genotype, nutritional status, meconium ileus, and pancreatic enzyme
supplementation were not significantly associated with pathological GOR.
CONCLUSIONS
About one in five newly diagnosed
infants with cystic fibrosis had pathological GOR. Pathologically
increased reflux was present before radiological lung disease was
established. Apart from frequent vomiting, no useful clinical
predictors of pathological reflux were found.
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