Department of Pediatrics, A, Hôpital Cochin-Saint Vincent de Paul, Paris,
Laboratory of Biochemistry A, Hôpital Cochin-Saint Vincent de Paul, Paris
Department of Pediatrics, Hôpital Saint Antoine, Université Catholique, Lille-France
Abstract
The purpose of our study was to systematically evaluate gastric acid output in children with long-lasting gastro-esophageal reflux (GER) in order to assess its mechanism and the need for anti-acid treatment.
The investigation was carried out in 20 males and 10 females, aged
7.5±3.8 years, with prolonged (>15 months) clinical manifestations of GER. All underwent
routine ambulatory 24-h esophageal pH-monitoring and measurement of gastric acid secretion including
gastric basal (BAO) (mmol/kg/h), maximal (MAO) and peak acid outputs
(PAO) after pentagastrin (6
When considering all children, esophageal pH (%)
was significantly correlated with MAO and PAO, r=0.33, p=0.05 and r=0.37, p=0.04, respectively.
Children of group B exhibited significantly higher BAO (75, 53.96-137.81), MAO (468, 394.1-671.3)
and PAO (617, 518.8-782.3) than those of group A, BAO (27, 10.8-38.5), MAO (266, 243.2-348.2) and
PAO (387, 322.5-452.7), p<0.05). The five children of group B with severe esophagitis exhibited
significantly higher BAO, MAO and PAO than the other 13 children from the same group and those of
group A, p<0.05.
Children with long-lasting and severe GER hyper-secrete gastric acid.
Individual variations in gastric acid secretion probably account for variations in gastric acid
inhibitor requirements. Anti-secretory treatment is justified in children with long-lasting GER and
high pH-metric reflux index.