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Correlation between laryngobronchoscopy and pepsin in the diagnosis of extra-oesophageal reflux

Published online by Cambridge University Press:  25 May 2015

U Krishnan ,
S Paul ,
I Messina  and
M Soma
U Krishnan
Affiliation:
Department of Paediatric Gastroenterology, Sydney Children's Hospital, Sydney, Australia School of Women's and Children's Health, University of New South Wales, Sydney, Australia
S Paul
Affiliation:
School of Women's and Children's Health, University of New South Wales, Sydney, Australia
I Messina
Affiliation:
Department of Paediatric Gastroenterology, Sydney Children's Hospital, Sydney, Australia School of Women's and Children's Health, University of New South Wales, Sydney, Australia
M Soma*
Affiliation:
Department of Paediatric Otolaryngology Head and Neck Surgery, Sydney Children's Hospital, Sydney, Australia School of Women's and Children's Health, University of New South Wales, Sydney, Australia
*
Address for correspondence: Dr M Soma, Department of Paediatric Otolaryngology Head and Neck Surgery, Sydney Children's Hospital, High St, Randwick, NSW 2031, Australia Fax: +61(2)9382–1787 E-mail: Marlene.Soma@sesiahs.health.nsw.gov.au
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Abstract

Objective:

This study aimed to investigate pepsin as a marker of extra-oesophageal reflux disease by examining its presence in tracheal aspirates and correlating it with macroscopic changes on laryngobronchoscopy, along with the results of standard tests for gastro-oesophageal reflux disease and clinical features.

Methods:

A retrospective review was undertaken of a cohort of 188 paediatric patients who underwent laryngobronchoscopy at a tertiary children's hospital and for whom pepsin assay results of tracheal aspirates were available. An association analysis was performed.

Results:

The mean patient age was 3.99 (3.40–4.58) years, with a male preponderance (55 per cent). Positive changes on laryngobronchoscopy were significantly associated with positive tracheal pepsin findings (p < 0.0001) but not with positive standard gastro-oesophageal reflux disease investigations. A positive pepsin assay was significantly associated with a history of recurrent croup (p = 0.0385) and a diagnosis of cystic fibrosis (p = 0.0232).

Conclusion:

Macroscopic changes on laryngobronchoscopy were significantly associated with positive tracheal pepsin findings in this paediatric population, suggesting that extra-oesophageal reflux disease may be a contributing aetiology.

Keywords

PepsinGastroesophageal RefluxLaryngoscopyBronchoscopyCroup
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 6 , June 2015 , pp. 572 - 579
Copyright
Copyright © JLO (1984) Limited 2015 

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Footnotes

Presented as a podium talk at the Annual Scientific Meeting of the Australian Society of Otolaryngology Head and Neck Surgeons, 30 March 2014, Brisbane, Australia

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