@article{krishnan2015management,
  title = {The Management of Children with Gastroesophageal Reflux and Respiratory Symptoms},
  author = {Usha Krishnan and Shaun Rama and Isabella Messina and Emily Horsley},
  year = 2015,
  url = {https://ibimapublishing.com/articles/GAST/2015/247821/},
  journal = {International Journal of Gastroenterology Research and Practice},
  volume = 2015 (2015),
  pages = 12,
  doi = 10.5171/2015.247821,
  abstract = {Research Motivation: Gastroesophageal reflux disease (GERD) is a well-recognised cause of respiratory symptoms in children. Confirming a diagnosis of reflux aspiration remains difficult, due to limitations in currently available investigations. The presence of pepsin in respiratory secretions has been documented in literature as a marker of reflux aspiration; however the correlation of pepsin assay results with clinical outcomes has not previously been reported. Aim:This study investigates the way in which results of pepsin assays influence the management of children with suspected reflux aspiration, as well as clinician attitudes towards pepsin assay. Methodology: Retrospective chart review of 318 patient records from January 2005 — December 2009, at Sydney Children’s Hospital. Pepsin assay results were compared with results from other standard investigations for GERD. Findings: Children with GERD and respiratory symptoms were 1.8 times as likely to be positive for pepsin compared to children without respiratory symptoms (OR 1.8, 95% C.I. = 1.09 -2.96). A significantly greater quantity of pepsin was detected in tracheal aspirates of children with GERD and respiratory symptoms compared to those without (median 43, 0-996FU, p=0.002). In children with GERD and respiratory symptoms, pepsin assay, unlike standard GERD investigations was the only tool found to have statistical significance as a marker of possible reflux aspiration. Clinicians found the pepsin assay to be useful in the management of children with suspected reflux aspiration. Implications:  The findings of this study show that the pepsin assay helps in the assessment of children with GERD and respiratory symptoms in who reflux aspiration are suspected.},
  keywords = {pepsin; reflux; aspiration; GERD},
  note = Article ID: 247821
}