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J R Soc Med. 2004 January; 97(1): 49.
PMCID: PMC1079282

Gastro-oesophageal reflux

The article by Mr Issing and Mr Karkos (October 2003 JRSM1) brings into focus the role of gastro-oesophageal reflux in the aetiopathogenesis of many airway disorders. The supra-oesophageal complications of reflux are more common in children, especially infants, than in adults. Recurrent aspiration and reactive airway disease are particularly troublesome in children with severe neurodisability, often necessitating fundoplication or gastrotomy. Although clinical observations have suggested a possible link between reflux and otitis media, sinusitis and other upper-airway disorders, clinical evidence is lacking.2 Many infants with gastro-oesophageal reflux show improvement with age. For children, unlike adults, the optimum dosage and, more important, the safety profile of proton-pump inhibitors are yet to be established.3


1. Issing WJ, Karkos PD. Atypical manifestations of gastro-oesophageal reflux. J R Soc Med 2003;96: 477–80 [PMC free article] [PubMed]
2. Rudolph CD. Supraesophageal complications of gastroesophageal reflux in children: challenges in diagnosis and treatment. Am J Med 2003;115 Suppl3A: 150S–156S [PubMed]
3. Gibbons, TE, Gold BD. The use of proton-pump inhibitors in children: a comprehensive review. Paediatr Drugs 2003;5: 25–40 [PubMed]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press