Gastroesophageal reflux disease in children with recurrent croup

Krzysztof Ślączka¹, Marcin Dziekiewicz², Monika Jabłońska-Jesionowska¹, *Lidia Zawadzka-Głos¹

Summary
Introduction. Episodic croup occurs most often in children between 0.5 and 3 years of age. Recurrent croup presents most often in older children. It shows an association with gastroesophageal reflux disease, allergy and laryngeal abnormalities.
Aim. The aim of this study was to explore the relationship between recurrent croup and gastroesophageal reflux disease in children with the history of at least one episode of severe croup.
Material and methods. The study included 22 children with recurrent croup admitted to the Department of Pediatric Otolaryngology of the Medical University of Warsaw between the years 2013 and 2016. Information concerning leading symptoms and medical history was obtained from the medical documentation of the patients. All the patients underwent rigid laryngoscopy and were diagnosed using 24-hours, single probe esophageal pH monitoring.
Results. 22 children aged between 1.5 year to 7.5 years were examined and their medical records were analyzed. An acid reflux was diagnosed in fourteen patients (63.6%) and the mean Reflux Index was 11.6. On endoscopic examination of the larynx, 15 patients (61.8%) had normal findings, 7 patients (31.8%) were diagnosed with an airway abnormality including: 3 cases of laryngeal cleft (type I), 2 cases of laryngomalacia, 1 case of subglottic stenosis, 1 case of vocal fold nodules. In 5 cases (22.7%), GERD coexisted with larynx abnormalities.
Conclusions. All the children with recurrent croup should be diagnosed for both gastroesophageal reflux disease and laryngeal abnormalities. Therefore, ENT specialists, as well as gastroenterologists, should take part in diagnostic procedures to reveal primary conditions responsible for recurrent croup.

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