The role of gastroeosophageal reflux in children with chest pain

Chest pain is the third most common pain form after headache and myalgia in children. It is mostly seen in children between 10-12 years old. Etiology frequently depends on non cardiac reasons. In this age group, the most common etiologies for chest pain are chest wall skeletal-muscle system disorders or psycogenic factors. When these disorders are excluded, the most important reason is eosophageal disorders especially gastroesophagel reflux (GER). The aim of this study is to determine the frequency of GER in non cardiac chest pain (NCCP) in children. METHODS: 24 hour pH monitorization was performed in 31 patients between 7-18 years of age to detect GER whose chest pain could not be associated with any reason when evaluated in Pediatric Cardiology Policlinic. During the study, all patients continued their routine daily activity. RESULTS: 17 boys and 14 girls with mean age of 11,6±2,4 year were included in study. All patients had normal electrocardiography, telecardiography, ecocardiography and muscle enzyme levels. All patients had normal physical examination except two patients with epigastric tenderness. Nine patients (29.0 %) for proximal prob and 14 patients (45.2 %) for distal prob had pathologic values when pH<1 for proximal prob and pH<4 for distal prob were assumed to be cut-off values of reflux index in the results of the examined patients by 24 hour pH monitorization. DSCUSSON: There is limited number of study in childhood although there are various studies in adult age group in this topic. GER frequency found to be higher than normal population in NCCP with no etiology in our study. It is seen that abdominal pain accompanying chest pain increased the probability of the detection of GER. Key Words: Gastroesophageal reflux, 24 hour pH monitorization, noncardiac chest pain