Gastroesophageal reflux disease survey in 0-12 months congenital heart disease (CHD) patients with gastroesophageal reflux questionnaire revised I-GERQ- R)

ABSTRACT The incidence of congenital heart disease (CHD) varies from about 8/1,000 to 10/1,000 live births. Significant advances in surgical techniques and intensive care management have led to increased survival for children with CHD. Nutritional problems, malnutrition and growth retardation are among the major complications which is seen in children with CHD. Gastroesophageal reflux is a complication closely related to nutrition and causes growth retardation. Gastroesophageal reflux (GER) is one of the common complications in infants with CHD and causes recurrent pulmonary infections, growth and development retardation. GERD, we encountered a wide range, commonly encountered by pediatricians and still continues to work on pathophysiology and treatment, is the most common esophageal disorder in children. Because of the non-specificity of GERD symptoms and the lack of a gold-standard method of diagnosis, many diagnostic methods that classical or modern are used for diagnostic purposes. Among the modern methods used in GERD, there are still ongoing surveys. The questions in this questionnaire are shaped by the findings of the parents on their babies. The story can be facilitated and standardized by questionnaires. In this study, reflux questionnaires were prepared including the children in our country and their age-appropriate reflux symptoms. Infants aged 0-1 years who were admitted to Pediatric Cardiology and General Pediatric Polyclinics of the İnönü University School of Medicine Department of Pediatrics were included in the study were selected randomly and with the permission of their parents. 109 patients diagnosed with CHD and 81 healthy babies were included in the study. A total of 109 patients (51 female, 58 male), of whom 95 (47 female, 48 male) were acyanotic and 14 (4 female, 10 male) were cyanotic congenital heart disease and 81 boy) healthy child was included in the study. The median age of both groups was 5 months. Infants with a reflux score ≥ 7 were considered to be significant for reflux in our study. The rate of reflux was diagnosed 26.6% for the patients with congenital heart disease and 23.5% for the control group. GERD was seen at 4 months in 6 CHD patients (20.7%) and at 5 months control infants (26.3%) in our study. The age at which reflux was most visible in the period when the babies were 4 months old in both groups. We found that structural anomalies affecting reflux in CHD when assessed with logistic regression analysis for conditions that increase reflux score (age, sex, percentile value, type of CHD structural anomaly) in CHD. We found that patients with CHD with increased cyanotic pulmonary blood flow, increased the reflux score by 3.93 times (OR: 3,727, 95% CI: 1,016-19,169, p = 0.035). Our study is one of very few studies on the investigation of gastroesophageal reflux disease in patients with CHD. The I-GERQ-R questionnaire is a modern method that is easy to apply and non-invasive, family-friendly, used in GERD. GERD one of the factors causing growth retardation and malnutrition, should be kept in mind and families should be aware of GERD in infants with congenital heart disease. Keywords: CHD, congenital heart disease, GERD, reflux, questionnaire, scoring, vomiting, infant