New insights on gastro-oesophageal reflux in cystic fibrosis by longitudinal follow up

Article Abstract:

Cystic fibrosis is an inherited disease that causes the production of thick mucus which clogs the lungs, pancreas and intestines. Several studies have reported that many patients with cystic fibrosis experience gastroesophageal reflux (GER, the backflow of the acidic contents of the stomach up into the esophagus). It has been reported that GER is more common in patients with cystic fibrosis than in the general population. GER may result from respiratory or abdominal abnormalities caused by cystic fibrosis, yet GER seems to improve as the patient grows older, even as the cystic fibrosis becomes worse. To investigate this issue further, 26 children with cystic fibrosis, who were younger than five years of age, were tested for GER. GER was diagnosed by monitoring changes in relative acidity (pH) in the esophagus. During an episode of GER, the pH of the esophagus will decrease as acid from the stomach comes up into the esophagus. Eighty-one percent of the children with cystic fibrosis were diagnosed as having GER. Twelve out of 13 patients showed improvement in GER following one month of treatment with cisapride (a drug used to prevent GER). These patients were able to gain weight, and symptoms of cough and wheeze disappeared. The results of this study indicate that GER is common in young children with cystic fibrosis, but it does not result from respiratory or gastrointestinal complications. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Gastroesophageal reflux in children, Pediatric gastroesophageal reflux, Cystic fibrosis

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Bronchial provocation determined by breath sounds compared with lung function

Article Abstract:

Patients with asthma or chronic bronchitis often have bronchial hyperreactivity or bronchial spasm, in which the bronchial tubes constrict following stimulation by hormones or exposure to cold air. Bronchial reactivity is commonly evaluated in children with symptoms of asthma. This evaluation is most successfully done in older children and adults, as a series of breathing maneuvers must be repeated consistently. An alternative was recently proposed in which responses to a methacholine (a drug that causes wheezing) were similar whether measured as expired volume or by listening for tracheal (windpipe) wheeze with a stethoscope. The validity of the tracheal monitoring technique was carefully evaluated in 15 children aged 5 to 8 years. The dose causing wheezing and that causing a 20 percent decrease in expired volume correlated significantly. Blood oxygen levels decreased during the test. The report indicates that listening for wheezing over the trachea is an appropriate way to monitor bronchial responsiveness to methacholine in young children, but physicians should end the test when signs such as increased heart or respiratory rate appear. (Consumer Summary produced by Reliance Medical Information, Inc.)

Bronchial spasm, Bronchitis in children

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