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Prevalence of Symptoms of Gastroesophageal Reflux During Childhood
A Pediatric Practice-Based Survey
Suzanne P. Nelson, MD, MPH;
Edwin H. Chen, PhD;
Gina M. Syniar;
Katherine Kaufer Christoffel, MD, MPH;
for the Pediatric Practice Research Group
Arch Pediatr Adolesc Med. 2000;154:150-154.
Objectives To determine the prevalence of symptoms associated with gastroesophageal reflux (GER) in 3- to 17-year-old children, to describe the prevalence of factors associated with GER in these children, and to determine the percentage of symptomatic children who have been treated.
Design A cross-sectional survey.
Setting Sixteen pediatric practice research group practices in the Chicago, Ill, area (urban, suburban, and semirural).
Participants A total of 566 parents of 3- to 9-year-old children, 584 parents of 10- to 17-year-old children, and 615 children aged 10 to 17 years.
Intervention None.
Main Outcome Measure Reported frequency of symptoms associated with GER.
Results Parents of 3- to 9-year-old children reported that their children experienced a sensation of heartburn ("burning/painful feeling in middle of chest"), epigastric pain ("stomachache above belly button"), and regurgitation ("sour taste or taste of throw up") 1.8%, 7.2%, and 2.3% of the time, respectively. Parents of 10- to 17-year-old children reported that their children experienced the same symptoms 3.5%, 3.0%, and 1.4% of the time, while children aged 10 to 17 years reported the symptoms 5.2%, 5.0%, and 8.2% of the time, respectively. Complaints of abdominal pain ("stomachache") were most common, reported by 23.9% and 14.7% of parents of 3- to 9-year-old and 10- to 17-year-old children and by 27.9% of children aged 10 to 17 years. In those aged 10 to 17 years, heartburn reported by the children was associated with reported cigarette use (odds ratio, 6.5; 95% confidence interval, 2-21); no other complaint was associated with cigarette, alcohol, or caffeine consumption or passive smoking exposure. In 3- to 9-year-old children, no complaint was associated with caffeine consumption or passive smoking exposure. Reported treatment in the past week with antacids was 0.5% according to parents of children aged 3 to 9 years and 1.9% and 2.3% according to parents of children aged 10 to 17 years and children aged 10 to 17 years, respectively. Treatment with over-the-counter histamine receptor blockers was 0% for children aged 3 to 9 years and 10 to 17 years, as reported by their parents, and 1.3% for those aged 10 to 17 years, as reported by themselves.
Conclusions Symptoms suggestive of GER are not rare in childhood, yet only a fraction of children with symptoms are treated with over-the-counter antacids or histamine2 antagonists. Prospective longitudinal data are needed to determine which children with symptoms of GER actually have GER disease and are at risk of developing complications.
From the Divisions of Gastroenterology (Dr Nelson and Ms Syniar) and General Academic Pediatrics (Dr Kaufer Christoffel), Department of Pediatrics, and the Statistical Sciences and Epidemiology Programs (Drs Chen and Kaufer Christoffel), Northwestern University Medical School and Children's Memorial Medical Center, Chicago, Ill.
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