Factors affecting the frequency of gastroesophageal reflux in childhood corrosive esophageal burns

Aim: The aim of the study is to investigate the frequency of gastroesophagealreflux in corrosive esophageal stenosis and the factors affecting the frequency.Material and Method: Total 70 patients who admitted to our clinic due toingesting corrosive substances between 2003 and 2010, 52 of who developed stenosisand 18 of who did not, were included in the study. The patient groups created bywhether they developed stenosis and reflux were compared in terms of substances beingingested, the results of the investigation methods, the features of stenosis and thesuccess of the treatment.Findings: 70 patients with mean age of 48±35.9 (ranging from 6 to 170)months consisted of 40 boys and 30 girls. The frequency of reflux was foundsignificantly higher in the patients with stenosis (63.5%) than in the control groupwithout stenosis (33.3%) (p<0.05). 1.62 times higher reflux was detected in alkalistenosis. Reflux was diagnosed in 28 patients with esophageal pH monitoring and in 5patients with endoscopic esophagitis findings. While no significant difference wasdetected between the patient with and without reflux in terms of stenosis number andlocalization, the mean stenosis length was significantly higher in the patients with reflux(3.7±1.8 cm) than without reflux (2.2±1.0) (p<0.005). Longer stenosis increased the riskof reflux by 1.938 times. The mean treatment duration was 8.41±6.12 months in thepatients with reflux and 8.21±8.4 months in the other and no significant difference wasdetected between these two groups in terms of frequency of dilatation and the diameterof dilatators (p<0.05).Conclusion: Corrosive esophageal stenosis is often associated with refluxand the length of the stenosis is an important risk factor at this point. In short term, nonegative effect of reflux was shown upon dilatation treatment. Nevertheless, as the highfrequency of reflux increases the risk of esophagitis and Barrett esophagus, we suggestthat this group of patient should be followed due to the long-term effects of reflux andthese effects should be prospectively investigated in larger groups of patients.Key words: Corrosive esophageal stenosis, esophageal pH monitoring,esophagitis, esophagoscopy, gastroesophageal reflux.